Cyclic variation of the myocardial integrated backscatter signal in hypertensive cardiopathy: a preliminary study

Background Ultrasound tissue characterization studies realized through inte grated backscatter analysis with end-diastolic sampling in hypertensive car diopathy have demonstrated that abnormalities in the left ventricular myoca rdial ultrasonic texture are present in extreme forms of left ventricular h ypertrophy (LVH). Such abnormalities are not evident in the athlete's heart . The aim of the present study was to analyze the ultrasonic backscatter my ocardial indexes both as peak end-diastolic signal intensity and as cardiac -cyclic variation in two models of LVH: hypertensive cardiopathy and athlet e's heart. Methods Three groups of 10 subjects each, all men of mean age (31.6 +/- 3.5 years), and of comparable weight and height, were analyzed. Group A compri sed 10 cyclists of good professional level, while hypertensive patients wer e grouped in Group H. Both groups presented a comparable left ventricular m ass (LVM). Group C included 10 healthy subjects acting as controls. The men with hypertension were selected on the basis of the results of ambulatory monitoring of the blood pressure according to ISM-World Health Organization guidelines (International Society of Hypertension). A 2D-color Doppler ech ocardiography with a digital echograph Sonos 5500 (Agilent Technologies, An dover, Massachusetts, USA), was carried out on all the subjects in the stud y for conventional analysis of the LVM and function, The ultrasonic myocard ial integrated backscatter signal (IBS) was analyzed with an 'acoustic dens itometry' module implemented on a AT echograph, The signal was also sampled with a region of interest (ROI) placed at interventricular septum and at p osterior left ventricular wall level, The systo-diastolic variation of the backscatter was also considered, as cyclic variation index (CVIibs). Results According to the inclusion criteria, the LVM was comparable in grou ps A and H, but it was significantly higher than group C (left ventricular mass (body surface) (LVMbs) = 154.5 +/- 18.7 (A), 146.8 +/- 25.5 (H), 101.4 +/- 12.4 (C), p < 0.001). The end-diastolic IBS did not show significant s tatistical differences among the three groups, The CVIIBS both at septum (3 0.5 +/- 5.3 (A), 13.2 +/- 13.1 (H), 27.2 +/- 7.3(C), p < 0.002) and posteri or wall level (43.7 +/- 9.1 (A), 16.5 +/- 12.1 (H), 40.7 +/- 9.1(C), p < 0. 001) though, was significantly lower in the hypertensive patients than in b oth the athletes and the control group, where the results were comparable. Conclusion A significant alteration of the myocardial CVIibs (both for sept um and posterior wall) was found in the hypertensive model. This was probab ly the expression of an alteration in the intramural myocardial function. C oron Artery Dis 12:267-275 (C) 2001 Lippincott Williams & Wilkins.