Tissue characterization and tissue Doppler to discriminate between athletes and hypertensive patients

pp 112-118

Abstract

Introduction

The study objective was to assess the capability of tissue Doppler and tissue characterization to discriminate types of hypertrophy. 

Material and Methods

The study population consisted of 32 subjects (p) Group I: 13 hypertensive patients, Group II: 11 athletes; all with a left ventricular mass index (LVMI) > 124 g/m2; Group III: 8 volunteers. Overall systolic function was determined by echocardiography, regional function with tissue Doppler (TD) and regional tissue characterization (TC) by cyclic variation of the integrated backscatter (IBCV), and structure with integrated backscatter in dB (IB). 

Results

Shortening fractions (SF%): GI: 36.46 ± 4, GII: 33.9 ± 3, GIII: 35.1 ± 4.8, p= NS; mid-wall shortening fraction (MWSF %): GI: 26.9±3.5; GII: 27.5±4; GIII: 25±3, p=NS; "s" wave velocity by TD GI: 4.8±0.9; GII: 5.6 ± 0.8; GIII 5.4 ± 0.8; p= 0.04. CVIB dB: GI: 5.3 ± 2.5; GII: 7.6±2.1; GIII: 7.4±2.7, p=0.048. IB dB GI: 41±6; GII: 29±6; GIII: 31±7.3, p: 0.001. p=differential between GI and GII. 

GI and GII had normal systolic function by standard echocardiography. In TD  the "s" wave velocity was low in GI versus GII had normal systolic function by standard echocardiography. In TC the IB was high and IVCB low in GI in relationship to GII. In GII there was an incremental value of IBCV with incremental LVMI, suggesting a supernormal function. 

Conclusions:

Tissue Doppler and tissue characterization differentiated two types of hypertrophy in patients with hypertension and athletes. These changes were not found with standard echocardiographic manifestation of myocardial fibrosis and/or depressed ventricular function in pathological hypertrophy.