Amplitudes, Durations, and Timings of Apically Directed Left Ventricular Myocardial Velocities: II. Systolic and Diastolic Asynchrony in Patients with Left Ventricular Hypertrophy☆,☆☆,★
Section snippets
Study Subjects
Eighteen consecutive patients with LV hypertrophy defined as LV free wall thickness of 12 mm or more were prospectively recruited for the study if they also met the following criteria: (1) presence of normal sinus rhythm, (2) absence of intraventricular conduction abnormalities, (3) absence of segmental wall motion abnormalities, history of angina, or a myocardial infarction, (4) LV ejection fraction of G55%, and (5) absence of significant mitral or aortic valve disease. All patients had a
Baseline Patient Characteristics
The baseline echocardiographic characteristics are summarized in Table 1 and are contrasted with those of the normal control group.
Empty Cell Normal LV hypertrophy p Value RR interval (msec) 871 ± 169 951 ± 178 NS LV isovolumic relaxation time (msec) 92 ± 19 121 ± 41 <0.01 E wave amplitude (cm/sec) 80 ± 26 75 ± 24 NS E wave deceleration time (msec) 194 ± 50 234 ± 67 <0.05 E wave duration (msec) 238 ± 53 252 ± 53 NS Q wave to onset of E wave (msec) 450 ± 45 494 ± 48 <0.01 A wave amplitude
DISCUSSION
Results of this study indicate that patients with secondary LV hypertrophy and preserved global systolic performance have altered systolic and diastolic LV myocardial mechanics along the major axis. These abnormalities uncovered by the analysis of regional myocardial velocities include (1) asynchrony in the onset of myocardial contraction circumferentially, (2) presence of postejection LV shortening, (3) asynchrony in the onset of early myocardial lengthening circumferentially, (4) reduced
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From the Sections of Cardiology, Jerry L. Pettis VA Medical Center and Loma Linda University School of Medicine.
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Reprint requests: Ramdas G. Pai, MD, FRCP(E), Cardiology (111C), Jerry L. Pettis VA Hospital, 11201 Benton St., Loma Linda, CA 92357.
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