[Differential diagnosis of idiopathic cardiomyopathy from ischemic cardiomyopathy and hypertensive heart disease using non-invasive methods].
Although, the diagnosis of idiopathic cardiomyopathy is determined by cardiac catheterization including myocardial biopsy, non-invasive diagnosis is important. The most useful method is nuclear cardiology to differentiate dilated cardiomyopathy from ischemic cardiomyopathy. Cardiac images in ischemic cardiomyopathy have wider perfusion and metabolic defects than in dilated cardiomyopathy using Tl-201, Tc-99m perfusion tracers, I-123 BMIPP, N-13 NH3 and F-18 FDG. The degree of heterogenecity of the myocardium is higher in ischemic cardiomyopathy than in dilated cardiomyopathy by these tracers. Left ventricular hypertrophy is common finding in hypertension and hypertrophic cardiomyopathy. However, in hypertensive heart disease the left ventricular wall thickness rarely exceed than 20 mm, and the septal wall thickness/posterior wall thickness is not more than 1.5, which are frequently shown in hypertrophic cardiomyopathy. Right ventricular hypertrophy near the ventricular septum is also one of the characteristic findings in hypertrophic cardiomyopathy.
Masuda
Y
Y
Third Department of Internal Medicine, Chiba University School of Medicine.
D002311:Cardiomyopathy, Dilated / Q000175:diagnosis* / Q000209:etiology; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis* / Q000209:etiology; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000209:etiology