J Korean Soc Echocardiogr.  1994 Dec;2(2):192-198. 10.4250/jkse.1994.2.2.192.

Echocardiographic Differences between Hypertrophic Cardiomyopathy and Hypertensive Left Ventricular Hypertrophy

• Jeong JW
• Park OK

• KMID: 2410448
• DOI: http://doi.org/10.4250/jkse.1994.2.2.192

Abstract

OBJECTIVES
To define the differnce in echocardiographic features between hypertrophic cardiomyopathy(HCM) and severe left ventricular hypertrophy(LVH) accompanying hypertension. METHOD: Two-dimensional, M-mode and Doppler echocardiography were performed in both 16 subjects with typical HCM(Group 1) and 22 subjects with severe LVH accompanying hypertension(Group 2). We andalyzed the echocardiographic features such as distribution of LV hypertrophy, systolic anterior motion of mitral valve(SAM), LV outflow Doppler pressure gradient, interventricular septal thickness(IVST), LV posterior wall thickness(LVPWT). systolic IVS excursion (IVSa) and LVPW excursion (LVPWa), LVPWa/IVSa, LV end-diastolic (LVEDD) and end-systolic dimension (LVESD), fractional shortening(% FS), isovolumic relaxation time(IVRT), peak mitral early filling velocity(peak E), peak atrial filling velocity(peak A) and diastolic deceleration time(DT) from the videotape recordings.
RESULTS
1) There were no definite clinical or electrocardiographic difference between two groups of the subject, except high blood pressure in group 2. 2) By echocardiography, mean LVPWT wa larger in group 2 compared with the HCM group(14±2 vs 11±2mm, p < 0.001), but asymmetric septal hypertrophy(ASH) was more frequent(IVST/LVPWT, 1.7±0.5 vs 1.2±0.2, p < 0.001) in HCM group than in LVH group. 3) IVSa was reduced(6±2 vs 8±2mm). but LVPWa/IVSa ratio was higher(2.3±1.2 vs 1.7±0.4, p < 0.05) in HCM group than in LVH group.
CONCLUSION
We conclude that echocardiographic differentiaton between HCM and LVH accompanying hypertension is very difficult, but LVPWT, IVSa from M-mode echocardiography and LVPWa/IVSa ratio seem to be helpful indices, complementary to SAM or ASH, to differentiate each other.

Keyword

Hypertrophic cardiomyopathy; Hypertension; Echocardiography

MeSH Terms

Cardiomyopathy, Hypertrophic*
Deceleration
Echocardiography*
Echocardiography, Doppler
Electrocardiography
Hypertension
Hypertrophy
Hypertrophy, Left Ventricular*
Methods
Relaxation
Videotape Recording

Figure

• 

  Fig. 1. M-mode echocardiographic measurement of interventricular septal excursiob(IVSa). left ventricular posterior wall excursion(PWa) in the hypertrophic cardiomyopathy(A) and the hypertensive left ventricular hypertrophy(B).

Reference

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