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Myocardial velocity gradient as a noninvasively determined index of left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy

Tomoko Kato, MD^*, Akiko Noda, PhD, Hideo Izawa, MD, PhD, Takao Nishizawa, MD^*, Fuji Somura, MD, PhD, Akira Yamada, MD, Kohzo Nagata, MD, PhD, Mitsunori Iwase, MD, PhD, FACC, Akimasa Nakao, MD, PhD and Mitsuhiro Yokota, MD, PhD, FACC^*,*

^* Cardiovascular Division, Department of Clinical Pathophysiology, Nagoya University, Graduate School of Medicine, Nagoya, Japan
Department of Surgery II, Nagoya University, Graduate School of Medicine, Nagoya, Japan
First Department of Internal Medicine, Nagoya University, Graduate School of Medicine, Nagoya, Japan
Nagoya University School of Health Sciences, Nagoya, Japan

View larger version (75K): [in a new window]   Figure 1 Examples of posterior wall myocardial velocity gradient (MVG) (top), tissue Doppler imaging (TDI) M-mode images (middle), and corresponding transmitral flow velocity patterns (bottom) with electrocardiograms (ECG), phonocardiograms (PCG), tracings of left ventricular pressure (LVP), and first derivative of left ventricular pressure for a representative patient with hypertrophic cardiomyopathy. The arrow and blue line indicate the period of peak negative MVG. The peak negative MVG for this patient was –2.12/s.

View larger version (15K): [in a new window]   Figure 2 Comparison of peak negative myocardial velocity gradient (MVG) between hypertrophic cardiomyopathy (HCM) patients and control subjects.

View larger version (25K): [in a new window]   Figure 3 Correlation between peak negative myocardial velocity gradient (MVG) and left ventricular end-diastolic pressure (LVEDP) for all individuals subjected to cardiac catheterization (solid line; closed and open circles represent hypertrophic cardiomyopathy (HCM) patients and controls, respectively) and for HCM patients alone (dotted line).

View larger version (24K): [in a new window]   Figure 4 Correlation between peak negative myocardial velocity gradient (MVG) and pulmonary artery wedge pressure (PAWP) for all individuals subjected to cardiac catheterization (solid line; closed and open circles represent hypertrophic cardiomyopathy (HCM) patients and controls, respectively) and for HCM patients alone (dotted line).

View larger version (23K): [in a new window]   Figure 5 Correlation between peak negative myocardial velocity gradient (MVG) and tau determined by the derivative method (T1/2) for all individuals subjected to cardiac catheterization (solid line; closed and open circles represent hypertrophic cardiomyopathy (HCM) patients and controls, respectively) and for HCM patients alone (dotted line).