Tricuspid annular motion velocity as a differentiation index of hypertrophic cardiomyopathy from hypertensive heart disease

Hayashi, Shuji; Yamada, Hirotsugu; Nishio, S.; Hotchi, Junko; Bando, Mika; Takagawa, Yuriko; Saijo, Yoshifumi; Hirata, Yoshihiro; Sata, Masataka

doi:10.1016/j.jjcc.2014.08.005

Cited by 4 publications

(7 citation statements)

References 32 publications

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“…Some previous investigations have shown a sharp decrease in LV diastolic function in healthy women after 50–60 years of age, compared with men, suggesting that menopause might accelerate. [ 37 38 ] Moreover, postmenopausal state might be the independent and important risk factor for LVDD, although the LVDD of postmenopausal hypertensive women was affected by metabolic disorders. [ 39 ] Several animal studies have suggested that estrogen loss by ovariectomy-induced cardiomyocyte hypertrophy and cardiac fibrosis were important processes that contributed to LVDD.…”

Section: Discussionmentioning

confidence: 99%

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

et al. 2018

Chinese Medical Journal

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Background:Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.Methods:This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.Results:A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E’; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E’ to the late diastolic mitral annular velocity (E’/A’; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E’ (E/E’; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E’ (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E’/A’ (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E’ (r = 0.472; P = 0.003) and E’/A’ (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E’ (r = −0.590; P < 0.001), E/E’ (r = 0.454; P = 0.004), and E’/A’ (r = −0.377; P = 0.018).Conclusions:Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.Chinese Clinical Trial Register:ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.

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Section: Discussionmentioning

confidence: 99%

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

et al. 2018

Chinese Medical Journal

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“…Previous studies on differentiating HCM from HHD have mainly focused on family history, genetic testing, or multimodality imaging exams. 5,[7][8][9][10][11] In terms of the imaging method, instead of LVMI, conventional morphologic parameters, such as LVMWT and regional bulging in the interventricular septum, have appeared to be relatively sensitive in differentiating the two disorders. 30 However, Jonathan et al demonstrated that an asymmetric hypertensive phenotype could overlap with the HCM MLVWT in approximately one in five hypertensive subjects, 31 which complicates differentiation.…”

Section: Discussionmentioning

confidence: 99%

“…4 Studies aimed at differentiating the etiologies of hypertrophy have been carried out one after another. 5,[8][9][10][11] The different manifestations of late gadolinium enhancement (LGE) presenting in the hypertrophic myocardium in the two diseases have recently been recognized. 12 LGE tends to be more prevalent in HCM, but it is lesser in extent and density in HHD.…”

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confidence: 99%

An Integrated Algorithm for Differentiating Hypertrophic Cardiomyopathy From Hypertensive Heart Disease

Kong

Wang

et al. 2023

Magnetic Resonance Imaging

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BackgroundDifferentiating hypertrophic cardiomyopathy (HCM) from hypertensive heart disease (HHD) is challenging.PurposeTo identify differences between HCM and HHD on a patient basis using MRI.Study TypeRetrospective.PopulationA total of 219 subjects, 148 in phase I (baseline data and algorithm development: 75 HCM, 33 HHD, and 40 controls) and 71 in phase II (algorithm validation: 56 HCM and 15 HHD).Field Strength/SequenceContrast‐enhanced inversion‐prepared gradient echo and cine‐balanced steady‐state free precession sequences at 3.0 T.AssessmentMRI parameters assessed included left ventricular (LV) ejection fraction (LVEF), LV end systolic and end diastolic volumes (LVESV and LVEDV), mean maximum LV wall thickness (MLVWT), LV global longitudinal and circumferential strain (GRS, GLS, and GCS), and native T1. Parameters, which were significantly different between HCM and HHD in univariable analysis, were entered into a principal component analysis (PCA). The selected components were then introduced into a multivariable regression analysis to model an integrated algorithm (IntA) for screening the two disorders. IntA performance was assessed for patients with and without LGE in phase I (development) and phase II (validation).Statistical TestsUnivariable regression, PCA, receiver operating curve (ROC) analysis. A P value <0.05 was considered statistically significant.ResultsDerived IntA formulation included LVEF, LVESV, LVEDV, MLVWT, and GCS. In LGE‐positive subjects in phase l, the cutoff point of IntA ≥81 indicated HCM (83% sensitivity and 91% specificity), with the area under the ROC curve (AUC) of 0.900. In LGE‐negative subjects, a higher possibility of HCM was indicated by a cutoff point of IntA ≥84 (100% sensitivity and 82% specificity), with an AUC of 0.947. Validation of IntA in phase II resulted in an AUC of 0.846 in LGE‐negative subjects and 0.857 in LGE‐positive subjects.Data ConclusionA per‐patient‐based IntA algorithm for differentiating HCM and HHD was generated from MRI data and incorporated FT, LGE and morphologic parameters.Evidence Level3.Technical EfficacyStage 2.

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“…However, HCM can coexist with hypertension, leading to difficulty in differentiating it from hypertensive heart disease 21 , 23 . Compared to HCVD, patients with HCM are associated with a thicker right ventricular wall, greater ST-T changes, lower LV mass and fibrosis, and decreased tricuspid annular motion velocity early diastolic velocity (TAM-e′) 21 , 22 . The patients with comorbid HCM and hypertension tend to be older, and have higher risks of diabetes, coronary artery disease, and non-cardiac death 23 .…”

Section: Introductionmentioning

confidence: 99%

Mechanical dyssynchrony and diastolic dysfunction are common in LVH: a pilot correlation study using Doppler echocardiography and CZT gated-SPECT MPI

Tsai

Wang

Shiau

et al. 2018

Sci Rep

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Hypertrophic cardiomyopathy (HCM) is an often under-diagnosed cause of left ventricular hypertrophy (LVH). It affects 1/500 of the population, is the most commonly inherited cardiovascular disorder, and can present in apical, concentric, or septal forms. Although most patients are asymptomatic, sudden cardiac death can be the initial presentation of HCM. By retrospectively enrolling patients suspected of having three different types of HCM in the absence of epicardial coronary stenosis, we aimed to examine systolic and diastolic dysfunction and perfusion abnormalities using both Doppler echocardiography and state-of-the-art gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera and thallium-201. Both regional perfusion and gated SPECT parameters were collected in addition to diastolic parameters from Doppler echocardiography. The results showed that mild ischemia was common in patients suspected of having HCM, with a mean summed stress score of 4.7 ± 4.9 (score 0–4 in 17-segment model). The patients with HCM were associated with discernible left ventricular mechanical dyssynchrony, especially those with the apical form. In addition, diastolic dysfunction was prevalent and early to late ventricular filling velocity ratios were significantly different between groups. By combining gated-MPI and Doppler data, the trivial functional changes in HCM may be identified.

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Tricuspid annular motion velocity as a differentiation index of hypertrophic cardiomyopathy from hypertensive heart disease

Abstract: TAM-e' is a potentially useful index to differentiate HCM from HHD.

Cited by 4 publications

References 32 publications

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

Astragalus Membranaceus Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome

An Integrated Algorithm for Differentiating Hypertrophic Cardiomyopathy From Hypertensive Heart Disease

Mechanical dyssynchrony and diastolic dysfunction are common in LVH: a pilot correlation study using Doppler echocardiography and CZT gated-SPECT MPI

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