Title of article :
Early detection of biventricular involvement in myotonic dystrophy by tissue Doppler
Author/Authors :
Michele Parisi، نويسنده , , Maurizio Galderisi، نويسنده , , Milena Sidiropulos، نويسنده , , Chiara Fiorillo، نويسنده , , Roberta Lanzillo، نويسنده , , Arcangelo DʹErrico، نويسنده , , Michela Grieco، نويسنده , , Pasquale Innelli، نويسنده , , Lucio Santoro، نويسنده , , Oreste de Divitiis، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2007
Abstract :
Background
Myotonic dystrophy is associated with arrhythmias and risk of sudden death but also with symptoms of heart failure. Our study aimed to identify early biventricular dysfunction in asymptomatic patients with myotonic dystrophy by tissue Doppler.
Methods
Thirty-six patients with myotonic dystrophy (M/F = 20/16, mean age = 36.4 years), asymptomatic for heart failure, and 36 age- and sex-matched healthy controls underwent Doppler echocardiography and pulsed tissue Doppler of lateral mitral annulus and of tricuspid annulus.
Results
The two groups had similar body mass index, blood pressure, heart rate, cardiac mass and endocardial shortening. Standard Doppler showed significantly lower transmitral early (E) diastolic peak velocity, longer transmitral deceleration and isovolumic relaxation times and higher tricuspid inflow atrial peak velocity in myotonic dystrophy than in controls. Tissue Doppler of mitral annulus showed lower myocardial systolic velocity (p < 0.02), lower early diastolic velocity (Em) (p < 0.05) and atrial velocity (Am) (p < 0.005), but no difference of Em/Am ratio. At tricuspid annulus, Em and Em/Am ratio were lower (p < 0.02 and p < 0.005, respectively). The ratio between tricuspid inflow E velocity and Em, index of the degree of right ventricular filling pressure, was higher (p < 0.001) than in controls. Tissue Doppler derived left ventricular and right ventricular measurements were all associated with the disease condition, independent of age and heart rate.
Conclusions
Tissue Doppler identifies subclinical biventricular involvement in myotonic dystrophy. Early left ventricular myocardial systolic and diastolic changes are evident. Right ventricular dysfunction, involving myocardial relaxation and right ventricular filling pressure, might be the arrhythmogenic substratum of these patients.
Keywords :
Myotonic dystrophy , systolic function , Diastole , Doppler Echocardiography , tissue Doppler
Journal title :
International Journal of Cardiology
Journal title :
International Journal of Cardiology