Key result
HCM genotype-positive subjects without hypertrophy showed decreased Ea on the interventricular septum (WMD -1.822; 95% CI -3.104 to -0.541) and lateral wall, indicating early diastolic dysfunction.
Why the study?
Does tissue Doppler imaging detect diastolic dysfunction as an early manifestation in HCM genotype-positive subjects without left ventricular hypertrophy?
Meta-Analysis
Does tissue Doppler imaging detect diastolic dysfunction as an early manifestation in HCM genotype-positive subjects without left ventricular hypertrophy?
Tissue Doppler imaging can detect early diastolic dysfunction in hypertrophic cardiomyopathy genotype-positive individuals before the development of overt left ventricular hypertrophy.
Answers are grounded in this paper and cite their sources.
TDI-detected diastolic dysfunction in G+/LVH- HCM subjects supports early family screening; confirms preclinical changes precede hypertrophy but requires prospective validation.
OBJECTIVES: To evaluate whether diastolic dysfunction derived by tissue Doppler imaging (TDI) would be an earlier manifestation in genotype-positive hypertrophic cardiomyopathy (HCM) subjects without left ventricular hypertrophy (LVH). METHODS: We systematically searched Pubmed, Medline, and Web of Science with an upper date limit of June 2016 for studies evaluating the diastolic function of HCM genotype-positive subjects without hypertrophy (G+/LVH-). Based on the inclusion criteria, eligible studies were selected. The quality of selected studies was assessed by the Newcastle-Ottawa Scale before being included in the meta-analysis. The statistic data such as weighted mean difference (WMD) and 95% confidence interval (CI) were calculated by Stata 12.0 software. RESULTS: Seventeen studies were included in the systematic review, and 12 were finally involved in the meta-analysis. The G+/LVH- subjects showed decreased Ea derived by TDI on both the interventricular septum (WMD [95% CI] = -1.822 [-3.104, -0.541]) and lateral wall (WMD [95% CI] = -2.269 [-3.820, -0.719]), and increased E/Ea on both interventricular septum (WMD [95% CI] = 1.363 [0.552, 2.174]) and lateral (WMD [95% CI] = 1.339 [0.386, 2.293]) wall. CONCLUSIONS: Tissue Doppler imaging-derived diastolic dysfunction can be found in HCM genotype-positive subjects without hypertrophy.
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Liu et al. (2017) conducted a meta-analysis in Hypertrophic cardiomyopathy. Genotype-positive hypertrophic cardiomyopathy without hypertrophy (G+/LVH-) was evaluated on Ea derived by tissue Doppler imaging on the interventricular septum (WMD -1.822, 95% CI -3.104, -0.541). HCM genotype-positive subjects without hypertrophy showed decreased Ea on the interventricular septum (WMD -1.822; 95% CI -3.104 to -0.541) and lateral wall, indicating early diastolic dysfunction.
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