Echocardiographic abnormalities, including delayed mitral valve opening (in 78 of 100 patients), occur in secondary left ventricular hypertrophy and cannot separate it from hypertrophic cardiomyopathy.
Observational (n=130)
Can echocardiographic criteria differentiate secondary left ventricular hypertrophy from hypertrophic cardiomyopathy?
Standard echocardiographic criteria such as mitral valve opening delay and septal to posterior wall thickness ratio cannot reliably separate secondary left ventricular hypertrophy from hypertrophic cardiomyopathy.
Echocardiograms showing left ventricular cavity and mitral valve were recorded and digitised in 100 patients with secondary left ventricular hypertrophy caused by severe hypertension (23), aortic valve stenosis (21), fixed subaortic stenosis (13), and postoperative aortic stenosis (13), or regurgitation (30). Left ventricular dimension and its rate of change were determined and related to mitral valve opening. These values were compared with those from 30 patients with hypertrophic cardiomyopathy. In the patients with secondary left ventricular hypertrophy, cavity size and peak circumferential fibre shortening rate were normal. In diastole, the peak rate of increase of dimension was reduced in 56, and mitral valve opening, normally synchronous with minimum dimension, was delayed in 78, both the result of abnormal left ventricular relaxation. The septal to posterior wall thickness ratio was greater than 1-3 in 40. Values for delay in mitral valve opening were distributed bimodally in the population of patients with secondary left ventricular hypertrophy, with one subgroup in which it was normal and the other in which it was significantly delayed. The distribution of the latter, along with those of values of peak rate of dimension increase and septal to posterior wall thickness ratio were indistinguishable from those in the patients with hypertrophic cardiomyopathy. Abnormalities similar to those of hypertrophic cardiomyopathy therefore occur in patients with secondary left ventricular hypertrophy, and these echo- cardiographic criteria cannot separate the two conditions.
Gibson et al. (Mon,) conducted a observational in Secondary left ventricular hypertrophy and hypertrophic cardiomyopathy (n=130). Echocardiographic evaluation vs. Hypertrophic cardiomyopathy was evaluated on Echocardiographic features including left ventricular dimension, rate of change, mitral valve opening delay, and septal to posterior wall thickness ratio. Echocardiographic abnormalities, including delayed mitral valve opening (in 78 of 100 patients), occur in secondary left ventricular hypertrophy and cannot separate it from hypertrophic cardiomyopathy.