Hypertrophic Cardiomyopathy Is Associated with More Severe Left Ventricular Dyssynchrony than Is Hypertensive Left Ventricular Hypertrophy

Nagakura, Toshiki; Takeuchi, Masaaki; Yoshitani, Hidetoshi; Nakai, Hiromi; Nishikage, Tomoko; Kokumai, Michiko; Otani, Shinichiro; Yoshiyama, Minoru; Yoshikawa, Junichi

doi:10.1111/j.1540-8175.2007.00458.x

Cited by 46 publications

(35 citation statements)

References 23 publications

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“…This hypothesis is further supported by previous studies demonstrating a positive correlation between LA size and LV wall thickness [3,4,22] and a higher degree of cell damage and fibrotic change in the thicker ventricular wall [23]. Moreover, it was recently reported in a study of 2-dimensional speckle tracking that patients with HCM had more severe LV dyssynchrony than those with hypertensive heart disease [24]. Since the ventricular systolic phase coincides with LA relaxation, there may be transmission of the LV myocardial contraction pattern to the thinwalled LA, with a resultant increase in the degree of reservoir dyssynchrony.…”

Section: Present Observationssupporting

confidence: 75%

Left Atrial Dyssynchrony in Patients With Nonobstructive Hypertrophic Cardiomyopathy Evaluated by Myocardial Strain Imaging

et al. 2008

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Background. The present study was conducted to examine left atrial (LA) dyssynchrony, determined by echocardiographic myocardial strain imaging, in patients with hypertrophic cardiomyopathy (HCM). Methods.We studied 26 patients with HCM (20 men and 6 women, age, 66 7 years) and 25 normal subjects (controls). Tissue Doppler-based strain images were recorded in the apical 2-, 4-chamber, and long-axis views. The LA strain curve was obtained with the region of interest placed at the 5 LA segments, namely, the atrial septum, lateral wall, inferior wall, anterior wall, and posterior wall. We measured standard deviation (SD) of the time-periods between aortic valve opening and maximal strain (reservoir dyssynchrony index) and SD of the time-periods between mitral valve opening and minimal strain (emptying dyssynchrony index). (40 23 Conclusions. LA dyssynchrony can be present throughout the cardiac cycle in patients with HCM. LA dyssynchrony is more common in the reservoir phase and may be attributed to significant myocardial involvement. (J Echocardiogr 2008; 6: 46-53) Results. Compared with controls, patients with HCM had greater indexes of reservoir

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Section: Present Observationssupporting

confidence: 75%

Left Atrial Dyssynchrony in Patients With Nonobstructive Hypertrophic Cardiomyopathy Evaluated by Myocardial Strain Imaging

et al. 2008

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“…It was characterized by the prolongation of LV IRT, smaller Ea, and greater E/Ea compared to control subjects. Previous studies have demonstrated that the presence of severe LV dyssynchrony [2,5] and regional systolic and relaxation abnormalities were related to impaired global LV relaxation in HCM [3,4,6,18,19]. Moreover, another study showed that heterogeneous contraction of the hypertrophied region accounted for global relaxation impairment in HCM.…”

Section: Discussionmentioning

confidence: 93%

“…Heterogeneity of regional left ventricular (LV) function has been reported in hypertrophic cardiomyopathy (HCM) and this is considered to play an important role in the relaxation abnormality [1][2][3][4][5][6]. Recently, the presence of apex-to-base disparity in the regional timing of early diastolic LV lengthening, based on the electromechanical activation sequence of LV, has been recognized as an important determinant of LV systolic and diastolic properties in animal models [7,8].…”

Section: Introductionmentioning

confidence: 98%

Heterogeneity of apex-to-base dispersion in diastolic lengthening is related to impaired global left ventricular relaxation in patients with hypertrophic cardiomyopathy

et al. 2010

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“…1 There has been increased recognition that LV dyssynchrony also exists in patients without HF but with other cardiac diseases, including hypertension, 2 coronary artery disease (CAD) 3 and cardiomyopathy. 4,5 Dyssynchrony has been measured using a variety of echocardiographic parameters based on different imaging techniques, 6 including pulsed-wave tissue Doppler imaging (TDI), colorcoded TDI, tissue tracking, displacement mapping, strain and strain rate imaging, and tissue synchronization imaging. TDI is the most extensively tested method.…”

Section: Introductionmentioning

confidence: 99%

Impact of antihypertensive treatment on left ventricular systolic dyssynchrony in treatment-naïve hypertensive patients

et al. 2012

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Dyssynchrony is common in asymptomatic patients with hypertension. We sought to investigate the impact of antihypertensive treatment on dyssynchrony in patients with hypertension. A total of sixty patients who had uncomplicated hypertension that had never been treated (treatment-naïve hypertensive patients) underwent echocardiographic evaluations of left ventricular (LV) dyssynchrony at baseline and after a 6-month treatment with antihypertensive drugs. The measured parameters were as follows:(1) the s.d. of 12 LV-segment time-to-peak systolic velocities (Ts-SD12), and (2) the maximal difference between peak systolic velocities of any 2 of the 12 segments (Ts-Max). Patients with Ts-SD12 X33 ms or Ts-Max X100 ms were regarded as having LV systolic dyssynchrony. Patients with systolic dyssynchrony (group 1, n¼29) and without systolic dyssynchrony (group 2, n¼31) were compared. Among the patients in group 1, antihypertensive treatment significantly improved LV systolic dyssynchrony (DTs-SD12, À13.1 ms; Po0.001 and DTs-Max, À34.0 ms; P¼0.003), whereas it did not demonstrate additional benefit among group 2 patients. The change in LV systolic dyssynchrony was significantly associated with changes in the mean annulus E¢ velocity, mean annulus S¢ velocity and mean annulus E¢/A¢ ratio, but not with changes in blood pressure and LV mass index. It is likely that chronic antihypertensive treatment could reverse the LV systolic dyssynchrony and simultaneously improve subclinical systolic and diastolic function in patients with hypertension and LV systolic dyssynchrony. INTRODUCTIONIt is well known that left ventricular (LV) systolic or diastolic dyssynchrony is common in patients with heart failure (HF) and a normal QRS duration. 1 There has been increased recognition that LV dyssynchrony also exists in patients without HF but with other cardiac diseases, including hypertension, 2 coronary artery disease (CAD) 3 and cardiomyopathy. 4,5 Dyssynchrony has been measured using a variety of echocardiographic parameters based on different imaging techniques, 6 including pulsed-wave tissue Doppler imaging (TDI), colorcoded TDI, tissue tracking, displacement mapping, strain and strain rate imaging, and tissue synchronization imaging. TDI is the most extensively tested method.Hypertension is a major risk factor for LV hypertrophy and HF. Epidemiological studies have demonstrated that hypertension accounts for 50% of patients with HF. 7 Recently, it was demonstrated that LV systolic dyssynchrony was present in 24% of asymptomatic patients with hypertension. 2 Moreover, on the basis of results from the previous study, 8 the proportion of treatment-naïve hypertensives with LV systolic dyssynchrony was found to be 44.5%.

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Hypertrophic Cardiomyopathy Is Associated with More Severe Left Ventricular Dyssynchrony than Is Hypertensive Left Ventricular Hypertrophy

Abstract: The presence of LVH is thus not always associated with LV dyssynchrony. However, the greater reduction of regional strain and severe LV dyssynchrony in HCM may contribute to the adverse cardiovascular outcomes associated with this disease.

Cited by 46 publications

References 23 publications

Left Atrial Dyssynchrony in Patients With Nonobstructive Hypertrophic Cardiomyopathy Evaluated by Myocardial Strain Imaging

Left Atrial Dyssynchrony in Patients With Nonobstructive Hypertrophic Cardiomyopathy Evaluated by Myocardial Strain Imaging

Heterogeneity of apex-to-base dispersion in diastolic lengthening is related to impaired global left ventricular relaxation in patients with hypertrophic cardiomyopathy

Impact of antihypertensive treatment on left ventricular systolic dyssynchrony in treatment-naïve hypertensive patients

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