• DOI:10.1093/ejechocard/jeq108
• Corpus ID: 17125638

Three-layer ultrasonic tissue characterization of the ventricular septum is predictive of prognosis in patients with non-obstructive hypertrophic cardiomyopathy.

@article{Kawasaki2011ThreelayerUT,
  title={Three-layer ultrasonic tissue characterization of the ventricular septum is predictive of prognosis in patients with non-obstructive hypertrophic cardiomyopathy.},
  author={Tatsuya Kawasaki and Michiyo Yamano and Toshiro Kuribayashi and Satoshi Kaimoto and Shigeyuki Miki and Tadaaki Kamitani and Hiroaki Matsubara and Hiroki Sugihara},
  journal={European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology},
  year={2011},
  volume={12 2},
  pages={
          90-7
        }
}

• T. Kawasaki, M. Yamano, +5 authors H. Sugihara
• Published 1 February 2011
• Medicine
• European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology

AIMS
A necropsy study of patients with hypertrophic cardiomyopathy (HCM) who died at a young age exhibited marked disarray and fibrosis in the mid-wall layer of the left ventricular (LV) myocardium. We assessed ultrasonic tissue characteristics in the three layers of the ventricular septum (VS), and correlated the result with long-term prognosis in HCM.

METHODS AND RESULTS
The magnitude of cyclic variation of integrated backscatter (CV-IB) was calculated in the three layers of the VS and the whole aspect of the LV posterior wall in 58 non-obstructive HCM patients and 20 healthy controls. All HCM patients were prospectively followed for an average period of 7.1 years for the occurrence of cardiac death or hospitalization due to heart failure. Each CV-IB of four regions was lower in HCM patients than in controls (all P < 0.01). CV-IB of the VS mid-wall layer was lower in 14 HCM patients with cardiac events than in patients without (5.4 ± 0.6 vs. 7.4 ± 0.5 dB, P = 0.033) although CV-IB of three other regions did not differ between the two groups. The optical cut-off point of %CV-IB <90%, i.e. the ratio of CV-IB in the VS mid-wall layer to the mean value in the layers on both sides, was an independent predictor of cardiac events (hazard ratio, 6.12; 95% confidence interval, 1.62-66.6; P = 0.013), with a positive predictive value of 44% and particularly with a high negative predictive value of 91%.

CONCLUSION
Patients with non-obstructive HCM are not likely to undergo cardiac events in the near future, when the CV-IB value is not significantly lower in the VS mid-wall layer than in the layers on both sides.