Abstract 1584: Differentiation of Hypertensive Left Ventricular Hypertrophy from Nonobstructive Hypertrophic Cardiomyopathy on the Basis of Left Ventricular Torsion. - Persistent Pressure Loading Makes Torsion Increase
Background: The differentiation of hypertrophic nonobstractive cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (H-LVH) on the basis of morphological information obtained by conventional echocardiography is occasionally difficult and the impairment of left ventricular (LV) strain derived from tissue Doppler imaging in HCM has been reported. We investigated whether LV torsion from novel speckle-tracking could discriminate HCM from H-LVH.
Methods and Results: Seven patients with HCM (aged 47±14), 12 patients with H-LVH (aged 56±11), and 14 normal controls (aged 27±7) were studied. LV torsion was calculated on the basis of the rotation angles measured by speckle tracking in basal and apical short-axis images. The results were shown in the table⇓. A cut off value of 18 degree in LV torsion discriminated H-LVH from HCM with a sensitivity of 100%, specificity of 100%, and predictive accuracy of 100%.
Conclusions: The LV torsion of H-LVH increased although that of HCM did not significantly change compared with that of normal control. LV torsion could be useful to discriminate H-LVH from HCM, with increased rotation of apical LV reflecting persistent pressure overloading.