Diagnostic significance of early diastolic time intervals in patients with hypertrophic cardiomyopathy and myocardial hypertrophy due to essential hypertension.

Abstract

In order to differentiate hypertrophic cardiomyopathy (HCM) from myocardial hypertrophy due to essential hypertension (HT), echocardiogram, apexcardiogram and phonocardiogram were simultaneously recorded in patients with HCM (n = 22), HT (n = 34) and normal subjects (N) (n = 22). The following early diastolic time intervals were measured: 1) IIA-O time, 2) IIA-MVO time (IRT) and 3) MVO-O time. The IIA-O time was 119 +/- 9 msec in N, 159 +/- 31 in HT (p less than 0.001, vs N) and 228 +/- 57 in HCM (p less than 0.001, vs N and HT, respectively). The IIA-MVO time was 66 +/- 11 msec in N, 95 +/- 18 in HT (p less than 0.001, vs N) and 102 +/- 24 in HCM (p less than 0.001, vs N). The MVO-O time was 53 +/- 9 msec in N, 66 +/- 21 in HT and 126 +/- 48 in HCM (p less than 0.001, vs N and HT, respectively). These results showed that among the early diastolic time intervals HT was abnormal only in the IIA-MVO time. On the other hand, HCM had abnormalities not only in the IIA-MVO time but also in the MVO-O time. Both the IIA-MVO and the MVO-O times in hypertrophic non-obstructive cardiomyopathy were prolonged significantly as compared to those in obstructive one. Analysis of early diastolic time intervals may be very useful to differentiate HCM, especially of the non-obstructive type, from HT.