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USE OF DOPPLER TISSUE IMAGING M-MODE IN IDENTIFYING PATIENTS WITH LEFT VENTRICULAR HYPERTROPHY AND DIASTOLIC DYSFUNCTION
D G Mackenzie, S Harris, L Fenn, A White, N McDicken, D J Webb, M A Denvir. Department of Medical Sciences, University of Edinburgh, Edinburgh, UK
Left ventricular hypertrophy (LVH) is a marker of adverse cardiovascular risk. Measures of diastolic dysfunction are used to distinguish between pathological and physiological hypertrophy. Pulse wave Doppler of mitral inflow (MIF) is commonly used in the identification of patients with diastolic dysfunction, but is subject to pseudonormalisation. Assessment of mitral annulus (MA) velocity has been proposed as a solution to this problem and we have previously reported the use of pulsed wave (PW) Doppler Tissue Imaging (DTI) in distinguishing individuals with different types of LVH.
DTI M-mode of the MA may offer further advantages over PWDTI due to superior temporal resolution. We have therefore compared DTI M-mode (E', A' and isovolumic relaxation time (IVRT)) with conventional MIF velocities (E, A and IVRT) in 125 subjects. The study population comprised three groups: normals, fell runners with LVH (the physiological group) and patients with hypertension (HTN) or hypertrophic cardiomyopathy (HCM) (the pathological group). A comparison between DTI M-mode of the medial MA and MIF is shown. E' and IVRT' distinguished reliably between the groups while MIF did not. DTI allows improved discrimination between pathological and physiological groups when compared to the conventional method of MIF.
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A COMPARISON OF ESTIMATES OF LEFT VENTRICULAR MASS USING FUNDAMENTAL AND HARMONIC ULTRASOUND IMAGING
D G Mackenzie, S Harris, L Fenn, A White, D J Webb, N McDicken, M A Denvir. Department of Medical Sciences, University of Edinburgh, Edinburgh, UK
Following recent guidelines, a hypertensive patient will usually be commenced on anti-hypertensive medication if left ventricular hypertrophy (LVH) is identified. Harmonic imaging (HI) is available on most modern echo machines and often produces clearer images than fundamental imaging (FI). However HI has been observed to cause thickening of the endocardium and this may alter estimates …