Resumo

CHEJTMAN, Demian et al. Clinical Value of Tissue Doppler Analysis of Systolic Phase Contraction in the Discrimination of Physiological and Pathological Ventricular Hypertrophy. Rev. argent. cardiol. [online]. 2006, vol.74, n.3, pp.129-135. ISSN 1850-3748.

Introduction Left ventricular hypertrophy (LVH) presents different etiologies, evolutive states and prognosis. Pulse wave tissue Doppler (TD) can study several aspects of myocardial function through regional velocity analysis. Study Aim To assess the capability of TD (isovolumic contraction wave -IVCa- and regional systolic "s" wave) to discriminate between types of hypertrophy. Research Design and Methods The study population consisted of five groups: young healthy volunteers (G1, n = 10), adult healthy volunteers (G2, n = 8) and three groups of patients with left ventricular hypertrophy (left ventricular mass index [LVMI] >125 g/m²): athletes (G3, n = 10), hypertensive (G4, n = 10) and hypertrophic miocardiopathy patients (HMC) (G5, n = 8). We analysed tissue "s" wave in basal and medial septum, IVCa/s relation and "s" wave difference between basal and medial septum (DVMB). Results Age (years): G1, 33±8; G2, 53±5; G3, 32±10; G4, 51±14; G,5 51±12). LVMI (g/m²): G1, 90,5; G2, 95; G3, 138; G4, 178; G5, 161, p = 0.003). There were no differences between groups in mesoparietal shortening fraction (p = 0.3) and end systolic stress (p = 0.1). The "s" regional wave values were: G1, 5.62±1.41; G2, 5.41±0.85; G3, 5.57±0.71; G4, 4.86±0.63; G5, 3.99±1.02, p = 0.002). IVCa/s relations were: G1, 0.28±0.17; G2, 0.38±0.21; G3, 0.20±0.12; G4, 0.45±0.14; G5, 0.77±0.28, p = 0.001). DVMB was: G1, 1.99±0.5; G2, 1.71±0.3; G3 1.72±0.5, G4 1.42±0.4, G5 0.56±0.3, p = 0.001). IVCa/s relation < 0.38 discriminated between physiologic and pathologic hypertrophy (sensitivity 90% and specificity 88%). DVMB < 0.98 identified hypertrophic miocardiopathy with a 100% sensibility and 96% specificity. Conclusions Tissue Doppler could discriminate between different types of hypertrophy. Two indexes (IVCa/s and DVMB) can be used as new tools to differentiate physiological from pathological hypertrophy and between subtypes of hypertrophy.

Palavras-chave : Hypertrophy; Left ventricular; Echocardiography; Doppler.