Tissue Doppler Imaging Consistently Detects Myocardial Abnormalities in Patients With Hypertrophic Cardiomyopathy and Provides a Novel Means for an Early Diagnosis Before and Independently of Hypertrophy
Key result
Tissue Doppler imaging detected reduced myocardial velocities in mutation-positive subjects without left ventricular hypertrophy with 100% sensitivity and 93% specificity.
Why the study?
Does Tissue Doppler imaging detect myocardial abnormalities in patients with familial hypertrophic cardiomyopathy mutations before the development of left ventricular hypertrophy?
Population
73 adults comprising 30 subjects with familial hypertrophic cardiomyopathy, 13 subjects positive for FHCM…
Comparison
Tissue Doppler (TD) imaging vs Standard 2D and Doppler echocardiography, and…
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Supports TDI for preclinical detection in HCM mutation carriers; leaves open whether screening alters outcomes.
Key Points
- The study aims to determine if myocardial tissue Doppler velocities can reliably identify hypertrophic cardiomyopathy in the absence of left ventricular hypertrophy.
- Conducted 2D and Doppler echocardiography and TD imaging in 30 subjects with hypertrophic cardiomyopathy and 13 mutation-positive subjects without left ventricular hypertrophy.
- Included 30 age- and sex-matched controls for comparison.
- Analyzed left ventricular wall thickness, mass, and TD velocities.
- Left ventricular wall thickness and mass significantly greater in hypertrophic cardiomyopathy subjects (P < 0.01).
- Systolic and early diastolic TD velocities significantly lower in both mutation-positive subjects without left ventricular hypertrophy and hypertrophic cardiomyopathy patients compared to controls (P < 0.001).
- Reduced TD velocities demonstrated a sensitivity of 100% and specificity of 93% for identifying mutation-positives without left ventricular hypertrophy.
Study Design
Type
Case-Control (n=73)
Structured PICO
Does Tissue Doppler imaging detect myocardial abnormalities in patients with familial hypertrophic cardiomyopathy mutations before the development of left ventricular hypertrophy?
P
Population
73 adults (77% women) comprising 30 subjects with familial hypertrophic cardiomyopathy (FHCM), 13 subjects positive for FHCM mutations but without left ventricular hypertrophy (LVH), and 30 age- and sex-matched controls.
I
Intervention
Tissue Doppler (TD) imaging
C
Comparator
Standard 2D and Doppler echocardiography, and comparison against healthy controls
O
Outcome
Systolic and early diastolic TD velocities, and diagnostic accuracy (sensitivity and specificity) for identifying mutation-positives without LVHsurrogate
Main Result
p-value: p=<0.001
Tissue Doppler imaging can accurately identify myocardial abnormalities in patients with hypertrophic cardiomyopathy mutations even before the development of left ventricular hypertrophy.
Cite This Study
Nagueh et al. (2001) conducted a case-control in Familial hypertrophic cardiomyopathy (n=73). Tissue Doppler imaging vs. Healthy controls was evaluated on Systolic and early diastolic tissue Doppler velocities (p=<0.001). Tissue Doppler imaging detected reduced myocardial velocities in mutation-positive subjects without left ventricular hypertrophy with 100% sensitivity and 93% specificity.