Potential application of tissue Doppler imaging to assess regional left ventricular diastolic function in patients with hypertrophic cardiomyopathy: comparison with 123I-beta-methyl iodophenyl pentadecanoic acid myocardial scintigraphy.
BACKGROUND
Tissue Doppler imaging (TDI) has been utilized to evaluate left ventricular myocardial dysfunction in patients with hypertrophic cardiomyopathy (HCM); however, no clear explanation for the abnormality of TDI variables has been forthcoming.


OBJECTIVE
Peak negative myocardial velocity gradient (MVG) derived from TDI may correlate with a disorder of fatty acid metabolism in patients with HCM.


METHODS
Tissue Doppler imaging and 123I-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) myocardial scintigraphy were performed in 15 patients with asymmetric septal hypertrophy (mean age 47 +/- 18 years) and in 12 healthy controls (mean age 43 +/- 10 years).


RESULTS
In early 123I-BMIPP images, accumulation defects were observed in the ventricular septum in 12 patients and in the posterior wall in 8 patients with HCM. Peak negative MVG in the ventricular septum (1.1 +/- 0.5 vs. 2.8 +/- 0.5, p < 0.0001) and posterior wall (5.2 +/- 1.4 vs. 6.7 +/- 0.8, p < 0.01 ) was significantly lower in the HCM group than in the controls; also, these parameters were significantly lower in patients with than in those without a defect in the region in question. The peak negative MVG in the ventricular septum and posterior wall correlated inversely with the washout rate in all subjects.


CONCLUSIONS
Peak negative MVG according to TDI is related to disorder of fatty acid metabolism in the regional left ventricular myocardium of patients with HCM.
Yamada
Hirortsugu
H
Department of Cardiovascular Medicine, Section on Cardiovascular Imaging, the Cleveland Foundation, Cleveland, Ohio 44195-5064, USA.
Oki
Takashi
T
Yamamoto
Takashi
T
Tanaka
Hideji
H
Tabata
Tomotsugu
T
Wakatsuki
Tetsuzo
T
Nomura
Masahiro
M
Ito
Susumu
S
Thomas
James D
JD
D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000378:metabolism; D016022:Case-Control Studies; D003971:Diastole; D018619:Echocardiography, Doppler, Pulsed; D005227:Fatty Acids / Q000378:metabolism; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism; D011877:Radionuclide Imaging; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000378:metabolism
D005227:Fatty Acids; D007457:Iodine Radioisotopes; D007462:Iodobenzenes; C049338:iodofiltic acid