EVALUATION OF LEFT-VENTRICULAR DIASTOLIC HEMODYNAMICS FROM THE LEFT-VENTRICULAR INFLOW AND PULMONARY VENOUS FLOW VELOCITIES IN HYPERTROPHICCARDIOMYOPATHY

We evaluated the characteristics of left ventricular diastolic hemodyn amics in hypertrophic cardiomyopathy (HCM) by measuring left ventricul ar inflow (LVIF) and pulmonary venous flow (PVF) velocities in 62 pati ents with asymmetric septal hypertrophy and 34 normal controls. The pa tients were divided into four groups according to the LVIF pattern and left ventricular end-diastolic pressure (LVEDP): 1) the pseudonormali zation group; 13 patients with the ratio of peak atrial systolic (A) t o early diastolic (E) LVIF velocity (A/E) less than or equal to 1 and LVEDP greater than or equal to 15 mm Hg, 2) the normal pattern group; 10 patients with the A/E less than or equal to 1 and LVEDP < 15 mm Hg, 3) the relaxation failure group; 25 patients with the A/E > 1, and 4) the mid-diastolic wave group; 14 patients with a mid-diastolic wave. The peak early diastolic LVIF velocities in the pseudonormalization, r elaxation failure and mid-diastolic wave groups were significantly sma ller than in the control group. The deceleration time from the peak of the E wave and the isovolumic relaxation time were significantly prol onged in the relaxation failure and mid-diastolic wave groups. The pea k diastolic PVF velocity in the relaxation failure and mid-diastolic w ave groups was significantly decreased, and was significantly increase d in the pseudonormalization group. The peak atrial systolic PVF veloc ity was significantly increased in all patients with HCM, particularly in the pseudonormalization group. LVEDP was the highest in the pseudo normalization group, followed by the mid-diastolic wave, relaxation fa ilure and normal pattern groups, in that order. In conclusion, combine d analysis of the: LVIF and PVF provides useful information regarding various abnormalities of left ventricular diastolic hemodynamics in pa tients with HCM.