DIFFERENCE IN SYSTOLIC MOTION VELOCITY OF THE LEFT-VENTRICULAR POSTERIOR WALL IN PATIENTS WITH ASYMMETRIC SEPTAL HYPERTROPHY AND PRIOR ANTEROSEPTAL MYOCARDIAL-INFARCTION - EVALUATION BY PULSED TISSUE DOPPLER IMAGING

The left ventricular (LV) posterior wall in patients with asymmetric s eptal hypertrophy or prior anteroseptal myocardial infarction (A-MI) f requently demonstrates normal or supernormal motion to compensate for hypokinesis of the interventricular septum. This study evaluated the s ystolic motion velocity of the posterior wall in these conditions usin g a pulsed tissue Doppler imaging system. The study population consist ed of 30 patients with hypertrophic cardiomyopathy (HC) and asymmetric septal hypertrophy, 25 with prior A-MI and 30 normal controls. The sy stolic excursion of the posterior wall was obtained by M-mode echocard iography. The endocardial motion velocities of the posterior wall were obtained by pulsed tissue Doppler imaging. The systolic excursion of the posterior wall was significantly greater in the A-MI and HC groups than in the control group, and was significantly greater in the A-MI group than in the HC group. The peak systolic velocity of the posterio r wall was significantly lower in the HC group than in the control and A-MI groups, and the time from the electrocardiographic Q wave to the peak of the systolic wave of the posterior wall was significantly lon ger in the HC group than in the other groups. There were rough negativ e and positive correlations between the LV end-diastolic pressure and the peak systolic velocity and time from the Q wave to the peak of the systolic wave, respectively. In conclusion, LV myocardial contractili ty in HC patients was impaired when compared to A-MI patients despite similar posterior wall motion on the M-mode echocardiogram. Pulsed tis sue Doppler imaging method may provide new insights and allow further evaluation of myocardial dysfunction.