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European Journal of Echocardiography 2004 5(5):356-366; doi:10.1016/j.euje.2004.01.003
© 2004 by European Society of Cardiology
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Copyright © 2004, The European Society of Cardiology

Biventricular diastolic behaviour in patients with hypertrophic and hereditary hemochromatosis cardiomyopathies

Przemyslaw Palkaa,*, Aleksandra Langea, John Athertonb, Wayne J. Stafforda and Darryl J. Burstowc

aSt Andrew's Heart Institute, Brisbane, Australia
bDepartment of Cardiology, Royal Brisbane Hospital, Brisbane, Australia
cDepartment of Echocardiography, Prince Charles Hospital, Brisbane, Australia

Received 27 May 2003; received in revised form 24 December 2003; accepted after revision 5 January 2004.

* Corresponding author. St Andrew's Heart Institute, St Andrew's Place; Level 5, Suite 335, 33 North Street, Brisbane, Qld 4000, Australia. Tel.: +61-7-3834-4353; fax: +61-7-3831-6663. drpalka{at}sawmh.com.au


  Abstract

Aim: To define biventricular diastolic behaviour in patients with cardiomyopathies with predominant diastolic left ventricular (LV) dysfunction.

Methods and results: Doppler tissue echocardiography and both mitral and tricuspid Doppler inflow profiles were investigated in hypertrophic (n = 17), hereditary hemochromatosis (n = 12) cardiomyopathies and age-matched normals (n = 31). The cardiomyopathy group had both lower early diastolic mitral lateral annular (El), cm/s (13.9±6.5) and medial (Em) (10.0±4.5) velocities compared with normals (19.5±5.5, 15.9±3.4, p<0.01, respectively). In the cardiomyopathy group, late isovolumic relaxation myocardial velocity gradient (IVR-MVG) (s–1) was positive compared with negative in normals (1.3±1.3 vs. –0.7±1.4, p<0.01, respectively). In both the cardiomyopathy group and in normals the onset of the tricuspid E-wave preceded the onset of the mitral E-wave. However, the onset of early diastolic tricuspid annular (Et) motion preceded the onset of El (ms) only in normals, but not in the cardiomyopathies (43±26 vs. –8±44, p<0.01, respectively). In the cardiomyopathy group there was a positive correlation between the onset of Et and abnormally positive late IVR-MVG (r = 0.51, p = 0.002).

Conclusions: Biventricular early diastolic behaviour is abnormal in the selected group of cardiomyopathy patients. The delay in the Et (early diastolic longitudinal right ventricular relaxation) may have a negative effect on LV diastolic function.

Keywords: Cardiomyopathies; Doppler echocardiography; Diastolic dysfunction


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