Myocardial contrast echocardiography for the distinction of hypertrophic cardiomyopathy from athlete's heart and hypertensive heart disease.

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State: Serval
Version: author
Serval ID
serval:BIB_5051959528A7
Type
Article: article from journal or magazin.
Collection
Publications
Title
Myocardial contrast echocardiography for the distinction of hypertrophic cardiomyopathy from athlete's heart and hypertensive heart disease.
Journal
Swiss medical weekly
Author(s)
Indermühle A., Vogel R., Rutz T., Meier P., Seiler C.
ISSN
1424-3997 (Electronic)
ISSN-L
0036-7672
Publication state
Published
Issued date
28/11/2009
Peer-reviewed
Oui
Volume
139
Number
47-48
Pages
691-698
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Myocardial contrast echocardiography (MCE) is able to measure in vivo relative blood volume (rBV, i.e., capillary density), and its exchange frequency b, the constituents of myo-cardial blood flow (MBF, ml min-1 g-1). This study aimed to assess, by MCE, whether left ventricular hypertrophy (LVH) in hypertrophic cardiomyopathy (HCM) can be differentiated from LVH in triathletes (athlete's heart, AH) or from hypertensive heart disease patients (HHD).
Sixty individuals, matched for age (33 +/- 10 years) and gender, and subdivided into four groups (n = 15) were examined: HCM, AH, HHD and a group of sedentary individuals without LVH (S). rBV (ml ml-1), b (min-1) and MBF, at rest and during adenosine-induced hyperaemia, were derived by MCE in mid septal, lateral and inferior regions. The ratio of MBF during hyperaemia and MBF at rest yielded myocardial blood flow reserve (MBFR).
Septal wall rBV at rest was lower in HCM (0.084 +/- 0.023 ml ml-1) than in AH (0.151 +/- 0.024 ml ml-1, p <0.01) and in S (0.129 +/- 0.026 ml ml-1, p <0.01), but was similar to HHD (0.097 +/- 0.016 ml ml-1). Conversely, MBFR was lowest in HCM (1.67 +/- 0.93), followed by HHD (2.8 +/- 0.93, p <0.01), by S (3.36 +/- 1.03, p <0.001) and by AH (4.74 +/- 1.46, p <0.0001). At rest, rBV <0.11 ml ml-1 accurately distinguished between HCM and AH (sensitivity 99%, specificity 99%), similarly MBFR < or =1.8 helped to distinguish between HCM and HHD (sensitivity 100%, specificity 77%).
rBV at rest, most accurately distinguishes between pathological LVH due to HCM and physiological, endurance-exercise induced LVH.

Keywords
Adult, Athletes, Blood Flow Velocity/physiology, Blood Volume/physiology, Cardiomyopathy, Hypertrophic/diagnostic imaging, Cardiomyopathy, Hypertrophic/physiopathology, Diagnosis, Differential, Female, Humans, Hyperemia/diagnostic imaging, Hypertension/diagnostic imaging, Hypertension/physiopathology, Hypertrophy, Left Ventricular/diagnostic imaging, Hypertrophy, Left Ventricular/physiopathology, Male, Microcirculation/physiology, Rest, Ultrasonography
Pubmed
Web of science
Create date
07/08/2017 12:22
Last modification date
05/06/2018 18:54
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