DIAGNOSTIC VALUE OF SYSTOLIC TIME INTERVALS IN HYPERTROPHIC CARDIMYOPATHY WITH SPECIAL REFERENCE TO ASSESSMENT OF LEFT VENTRICULAR OUTFLOW OBSTRUCTION

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Left ventricular systolic time intervals (STI) at rest was examined by carotid pulse tracing in 37 patients with hypertrophic cardiomyopathy (HCM) consisting of 13 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 24 patients with hypertrophic nonobstructive cardiomyopathy (HNOCM). These values were compared to peak systolic pressure gradient (pSPG) and mean systolic pressure gradient (mSPG) determined by cardiac catheterization at rest. In patients with HOCM, Q-II c (corrected Q-II time) and LVETc (corrected left ventricular ejection time) were elongated, PEPc (corrected preejection period) was shortened and PEP/LVET (preejection period/left ventricular ejection time) was low compared to those in patients with HNOCM and in normal subjects. In patients with NHOCM, LVETc was shortened, PEPc was elongated and PEP/LVET was high compared to those in patients with HOCM and in normal subjects. In patients with HOCM, Q-II c and LVETc were positively correlated with pSPG (r = 0.714, r= 0.810, respectively) and mSPG (r = 0.884, r =0.930 respectively). Furthermore, PEP/LVET was negatively correlated with pSPG (r= 0.865) and mSPG (r= 0. 851). It is concluded that STI determined by carotid pulse tracing is an useful diagnostic method in differentiating HOCM from HNOCM, moreover it may be possible to assess noninvasively the degree of systolic pressure gradient in patients with HOCM.
北関東医学会の論文