Effect of hypertrophy on left ventricular diastolic function in patients with hypertrophic cardiomyopathy
Abstract
Overview
Background. Hypertrophic cardiomyopathy (HCM) is characterized by asymmetric
LV hypertrophy (LVH) and impairment in diastolic function. We assess the relationship between
LVH and invasive indexes of diastolic function.
Methods. 21 HCM patients underwent cardiac catheterization to assess pulmonary capillary
wedge pressure, LV end-diastolic pressure (measured by microtip catheters), and LV volumes
(calculated by simultaneous radionuclide angiography). We calculated from LV pressure the time
constant of isovolumetric relaxation (τ, variable asymptote method, ms), and from LV pressure
and volume the constant of chamber stiffness (k, ml-1). LVH was assessed by different indexes:
maximal wall thickness, number of hypertrophied LV segments, LVH index, and Wigle’s score.
Results. Wigle’s score was directly related to pulmonary capillary Wedge pressure (r=0.436,
p=0.048), peak V wave of pulmonary capillary wedge pressure (r=0.503, p=0.024), LV end-diastolic
pressure (r=0.643, p=0.002) and k (r=0.564, p=0.015). HCM patients were divided into 2
groups according to Wigle’s score: 10 with mild or moderate LVH (< 8), and 11 with severe LVH
(≥ 8). HCM patients with severe LVH showed a higher pulmonary capillary Wedge pressure
(15.1±7.2 vs 9.5±2.4, p=0.033), peak V wave of pulmonary capillary wedge pressure (20.7±4.6
vs 14.6±4.9, p=0.011), LV end-diastolic pressure (23.9±10.9 vs 10.6±2.5, p=0.002), k
(0.0465±0.032 vs 0.015±0.007, p=0.022) and LV outflow tract gradient (72±36 mmHg vs 29±30
mmHg, p=0.01). τ was similar in the two groups. Other indexes of LVH were not related to diastolic
function.
Conclusions. Wigle’s score is the only index of LVH that relates to invasive indices of diastolic
function. (Heart International 2006; 2: 106-14)
Keywords
Cardiomyopathy, Diastole, Hypertrophy
Article Information
Correspondence
Sandro Betocchi, MD, FACC, FESC, Department of Clinical Medicine, Cardiovascular & Immunological Sciences, “Federico II” University School of Medicine, Via S. Pansini, 5, 80131 Naples – Italy, sandro.betocchi@unina.it
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