Differentiation between pathologic and physiologic left ventricular hypertrophy by tissue Doppler assessment of long-axis function in patients with hypertrophic cardiomyopathy or systemic hypertension and in athletes

To identify new echocardiographic indexes of long-axis function that might differentiate between pathologic and physiologic left ventricular (LV) hype rtrophy, we compared 60 subjects with different types of LV hypertrophy (gr oup I: 15 patients with hypertrophic cardiomyopathy, group II: 15 patients with systemic hypertension, and group III: 30 athletes) with 20 normal subj ects (group IV). The peak velocities of mitral annular motion at 4 sites we re measured from the apex by tissue Doppler echocardiography, There were no differences in mean age and global election fraction between groups. Group s I and II had lower long-axis systolic and early diastolic velocities than the athletes (p <0.01) for all 4 sites. The best differentiation of pathol ogic from physiologic hypertrophy was provided by a mean systolic annular v elocity <9 cm/s (sensitivity 87%, specificity 97%), Heterogeneity of annula r velocities discriminated between group I and group II. Thus, long-axis sy stolic and early diastolic velocities are decreased in patients with pathol ogic hypertrophy, but preserved in athletes. These simple new echocardiogra phic parameters can differentiate between pathologic and physiologic hypert rophy. (C) 2001 by Excerpta Medica, Inc.