Copyright © 2005, The European Society of Cardiology
Myocardial stiffness and the timing difference between tissue Doppler imaging Ea and peak mitral valve opening can distinguish physiological hypertrophy in athletes from hypertrophic cardiomyopathy
aCardiology Department, St James Hospital, Dublin 8, Ireland
bCardiovascular Therapeutics Unit, Department of Pharmacology, University of Melbourne, Australia
cUniversity of Tasmania, and Tasmanian Institute of Critical Care, Davenport, Tasmania, Australia
dDublin Institute of Technology, Kevin Street, Dublin, Ireland
eMedical Physics Department, St James Hospital, Dublin 8, Ireland
fDepartment of Pharmacology and Therapeutics, St James Hospital, Dublin 8, Ireland
Received 5 August 2005; received in revised form 22 September 2005; accepted after revision 30 September 2005.
* Corresponding author. Tel.: +353 1 416 2792; fax: +353 1 410 3467. gking{at}stjames.ie
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Abstract |
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Aim To differentiate between physiological and pathological left ventricular hypertrophy in athletes using echocardiography.
Methods and results Eleven patients with mild hypertrophic cardiomyopathy were compared against 17 international rowers with mild left ventricular hypertrophy, and 30 age matched controls. The time difference between peak Ea (Doppler tissue imaging) and peak mitral valve opening (using M-mode) was measured simultaneously. A novel index (E/Ea)/LVEDD, as a measure of left ventricular stiffness was recorded. In athletes the peak Ea preceded peak mitral opening by: median (interquartile range) 20ms (10,20), control group 15ms (0,30), compared with HCM where Ea followed peak mitral opening by 10ms (0,20), P<0.0001. In athletes the index of left ventricular stiffness was lower than controls 1.2 (0.93,1.4) versus 1.5 (1.3,1.6), and HCM 2.2 (2.0,2.3), P<0.0001.
Conclusion Physiological hypertrophy can be differentiated from hypertrophic cardiomyopathy in athletes using the Ea-peak mitral opening difference, and our index of ventricular stiffness.
Keywords: Left ventricular hypertrophy; Hypertrophic cardiomyopathy; Tissue Doppler imaging; Myocardial stiffness
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