Hypertrophic nonobstructive cardiomyopathy: A precise assessment of hemodynamic characteristics and clinical implications

Hirota, Yuzo; Furubayashi, Keiichi; Kaku, Kiyotaka; Shimizu, Gen; Kino, Masaya; Kawamura, Keishiro; Takatsu, T

doi:10.1016/0002-9149(82)90407-6

Cited by 51 publications

(16 citation statements)

References 27 publications

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“…Of the indices of left ventricular ejection, the ejection ease leading to disproportional and concentric hypertro phy of the left ventricle and is characterized by diastolic dysfunction of the left ventricle. In this condition, impair ment of left ventricular relaxation and early diastolic fill ing is found [1][2][3]. In the present study, a decrease in the RFVI and reduction in the PFR were also found.…”

Section: Left Ventricular Volume and Left Ventricular Ejection Indicessupporting

confidence: 75%

Impaired Left Atrial Compensation in Hypertrophie Cardiomyopathy

Shimizu¹,

Sugihara²,

Kita³

et al. 1992

Am J Noninvas Cardiol

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To determine to what degree left atrial function contributes to the maintenance of left ventricular function in hypertrophic cardiomyopathy (HCM), we investigated a group of 12 HCM patients as compared to 9 healthy controls using radionuclide (RN) angiography. Cardiac output was calculated by RN angiography using technetium-99m albumin. Next, time-activity curves were constructed by combined forward- and reverse-gating from the R wave. Using the data thus obtained, the left ventricular time-volume curve and its 1 st and 2nd derivative curves were constructed. The ejection fraction was significantly greater in the HCM group than in the control group (p < 0.01). In the rapid filling phase, the filling volume (23 ± 5 vs. 36 ± 6 ml/m^2, p < 0.001), filling fraction (0.58 ± 0.09 vs. 0.76 ± 0.05, p < 0.001) and peak filling rate (153 ± 37 vs. 222 ± 53/s/m2, p < 0.01) all showed lower values in the HCM group, while the time to peak filling rate was significantly prolonged in this group (p < 0.02). In the atrial systolic phase, the filling volume (13 ± 4 vs. 10 ± 3 ml/m^2, p < 0.05), filling fraction (0.33 ± 0.08 vs. 0.20 ± 0.06, p < 0.01) and peak filling rate (132 ± 45 vs. 84 ± 30 ml/s/m^2, p < 0.02) were all significantly increased in the HCM group as compared to the control group. However, the increase in filling volume in the atrial systolic phase was smaller than the decrease in filling volume in the rapid filling phase, and the left ventricular filling volume (= stroke volume) was significantly smaller in the HCM group than in the control group (p < 0.01). The above results suggest that although in the HCM group the contribution of the left atrium is increased and a compensatory mechanism is at work in response to the impairment of left ventricular early diastolic filling, this compensatory response is insufficient to restore normal left ventricular function.

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Section: Left Ventricular Volume and Left Ventricular Ejection Indicessupporting

confidence: 75%

Impaired Left Atrial Compensation in Hypertrophie Cardiomyopathy

Shimizu¹,

Sugihara²,

Kita³

et al. 1992

Am J Noninvas Cardiol

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“…Postulated mechanisms in adults include elevated LA pressure, impaired augmentation of stroke volume secondary to abnormal diastolic filling, or impairment in LA and LV systolic performance. 29,30 From the present study, a significantly shorter Doppler mitral A-wave to pulmonary reverse A-wave duration difference in symptomatic patients would suggest elevated LA pressure to be a similar hemodynamic mechanism in children. Children who were symptomatic also had significantly increased QRS duration and a significant propensity to dyssynchronous ventricular activation by ECG criteria.…”

Section: Exercise Capacitymentioning

confidence: 48%

Characterization of Left Ventricular Diastolic Function by Tissue Doppler Imaging and Clinical Status in Children With Hypertrophic Cardiomyopathy

et al. 2004

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“…28,29 Previous studies have also shown that patients with HCM often exhibit latent systolic dysfunction, even if the resting ejection fraction is supernormal or maintained as a result of decreased afterload. 6,7 Considering the difficulty of noninvasive assessment of 'true' systolic function in HCM, measurements of cardiac time intervals might have an additive value in the functional assessment of HCM. In addition, interstitial fibrosis or regional myocyte loss can occur in the hypertrophied segments in some patients with HCM, which might precede the progression to LV systolic dysfunction with LV remodeling, so-called end-stage heart failure.…”

Section: Myocardial Performance Index In Hcmmentioning

confidence: 99%