Age Dependency of Left Atrial and Left Ventricular Acoustic Quantification Waveforms for the Evaluation of Diastolic Performance in Left Ventricular Hypertrophy,☆☆,

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Abstract

We evaluated diastolic performance in 50 normal subjects and 50 patients with concentric left ventricular (LV) hypertrophy. Age-dependent normal values were determined for LV and left atrial (LA) acoustic quantification parameters. Pulsed wave Doppler echocardiography was also performed on all subjects. Patients with LV hypertrophy had higher peak velocities of atrial contraction and atrial contributions to filling. The acoustic quantification waveforms revealed lower rapid filling percentage of total filling and lower peak rapid filling rates. The LA acoustic quantification analysis confirmed the dependence on active atrial emptying in the patients with LV hypertrophy. There were significant correlations with age for most of the LV and LA acoustic quantification parameters. Acoustic quantification provided confirmatory results in subjects with an abnormal relaxation or restrictive Doppler pattern. In subjects with a normal Doppler pattern, the acoustic quantification was of added diagnostic value, identifying abnormalities in 77% to 80% of the patients. (J Am Soc Echocardiogr 1998;11:1027-35.)

Section snippets

Study Subjects

Fifty normal subjects (10 subjects in each decade from the fourth to the eighth) served as the control group. These subjects comprised both volunteers and patients referred to the echocardiographic laboratory. All subjects were without a history of systemic hypertension and normotensive at the time of their echocardiographic examination. All control subjects had normal LV systolic performance without regional wall motion abnormalities and a normal LV mass index with no more than trivial aortic

RESULTS

The average age in both groups was 55 years old. The LV masses were 128 ± 33 g (index 69 ± 15 g/m2 ) and 307 ± 103 g (index 170 ± 56 g/m2 ) in the control and LVH group, respectively. There were no intergroup differences in heart rate (71 ± 10 vs 74 ± 11).

DISCUSSION

Acoustic quantification, a technique based on integrated backscatter analysis, allows detection of the blood-tissue interface. This provides automated real-time acquisition of ventricular and atrial area waveforms over time. Although this technique has been extensively validated for the evaluation of LV systolic function, few studies have used this methodology to assess LV diastolic performance. Previous studies have been limited by both the small number of patients in the control groups (fewer

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From the Noninvasive Cardiac Imaging Laboratories, Department of Medicine, Section of Cardiology, University of Chicago.

☆☆

Reprint requests: Kirk T. Spencer, MD, Department of Medicine, Section of Cardiology, University of Chicago, 5841 South Maryland Ave, MC5084, Chicago, IL 60637.

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