Echocardiographic Tissue Doppler Imaging Analysis of the Systolic and Early Diastolic Velocities of the Mitral Annulus Motion in Hypertrophic Cardiomyopathy and in Top-Level Athletes

Background and Objective: Echocardiographic Tissue Doppler Imaging (TDI) has been proposed for the differentiation of pathological left ventricular hypertrophy (e.g. hypertrophic cardiomyopathy, HCM) and physiologic left ventricular hypertrophy (athlete's heart). The aim of this study was the TDI analysis of the systolic (S') and early diastolic (E') velocities in patients (pts.) with non-obstructive hypertrophic cardiomyopathy (HCM) and in top-level athletes in consideration of the previously published cut-off values (S' < 9 cm/s, E' < 9 cm/s). Patients and Methods: Pulsed-wave TDI of the systolic and early-diastolic velocities was performed at the lateral and septal mitral annulus in the four-chamber view in 17 HCM pts (12 men; mean age 44 +/- 16 years) and 30 consecutive athletes (80 men; mean age 26 +/- 5 years). Results: Pts with HCM showed significantly decreased systolic velocities of the septal (S' septal: 5.1 +/- 1.2 cm/s versus 9.5 +/- 1.5 cm/s, p < 0.001) and lateral mitral annulus (S' lateral: 6.4 +/- 2.0 cm/s vs. 10.5 +/- 2.1 cm/s, p < 0.001). The early diastolic velocity of the mitral annulus E' was significantly decreased in HCM, too (E' septal: 5.9 +/- 2.2 cm/s vs. 13.1 +/- 2.9 cm/s, p < 0.001: E' lateral: 8.2 +/- 3.0 cm/s vs. 16.5 +/- 3.4 cm/s, p < 0.001). Conclusion: Tissue Doppler Imaging of the systolic and early diastolic velocity of the mitral annulus might be helpful as a promising additional method for the echocardiographic differentiation between pathological and physiologic left ventricular hypertrophy.