Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 2, Number 2, April 2011, pages 72-78

Alteration of Time Intervals in Patients With Hypertrophic Cardiomyopathy During an Exercise Echocardiography

Figure 1. Time interval between the QRS complex and the onset of mitral early diastolic filling velocity - TE.

Figure 2. The interval between the QRS complex and the onset of peak early tissue mitral annular velocity - Te’.

**Table 1.** General and Echocardiographic Parameters
	HCM group	AH group	Normal controls	P-value 1	P-value 2
HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; BSA: body surface area; IMM: index myocardial mass; ILAVol: index of the left atrial volume; IVRT: isovolumetric relaxation time; E/A: ratio of the early filling (E) to the late diastolic filling (A) velocities; DT: deceleration time of the early diastolic velocity; PV S/D: ratio of the systolic (S) to early diastolic (D) velocities in the pulmonary vein; PV A’: the late diastolic velocity in the pulmonary vein; E/e’: ratio of the mitral to the annular early diastolic velocities; NS: non-significant difference.
P-value 1 was defined for comparison between HCM and AH groups.
P-value 2 was defined for comparison between AH and control groups.
General data
Age (years)	40 ± 13	46 ± 7	45 ± 7	NS	NS
Gender (M/F)	12/13	17/8	20/12	NS	NS
BSA (m²)	1.83 ± 0.20	2.00 ± 0.21	1.85 ± 0.20	0.006	0.003
Echocardiographic data
IMM (g/m²)	149 ± 44	86 ± 24	71 ± 15	0.0000001	0.008
ILAVol (ml/m²)	35 ± 12	29 ± 8	28 ± 7	0.04	NS
IVRT (ms)	101 ± 24	96 ± 18	80 ± 16	NS	0.0003
E/A	1.8 ± 0.8	1.2 ± 0.3	1.4 ± 0.4	0.0003	0.03
DT (ms)	198 ± 53	210 ± 56	182 ± 36	NS	0.005
A duration (ms)	113 ± 24	142 ± 26	133 ± 30	0.0003	NS
PV S/D	1.3 ± 0.4	1.3 ± 0.3	1.1 ± 0.3	NS	0.007
PV A’ (cm/s)	0.32 ± 0.07	0.30 ± 0.03	0.30 ± 0.05	NS	NS
A’ duration (ms)	115 ± 34	103 ± 27	93 ± 17	NS	NS
E/e’	6.5 ± 2.0	4.7 ± 1.5	4.1 ± 0.8	0.0008	0.05

Table 1. General and Echocardiographic Parameters

HCM group

AH group

Normal controls

P-value 1

P-value 2

N = 25

N = 34

HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; BSA: body surface area; IMM: index myocardial mass; ILAVol: index of the left atrial volume; IVRT: isovolumetric relaxation time; E/A: ratio of the early filling (E) to the late diastolic filling (A) velocities; DT: deceleration time of the early diastolic velocity; PV S/D: ratio of the systolic (S) to early diastolic (D) velocities in the pulmonary vein; PV A’: the late diastolic velocity in the pulmonary vein; E/e’: ratio of the mitral to the annular early diastolic velocities; NS: non-significant difference.

P-value 1 was defined for comparison between HCM and AH groups.

P-value 2 was defined for comparison between AH and control groups.

General data

Age (years)

40 ± 13

46 ± 7

45 ± 7

Gender (M/F)

12/13

17/8

20/12

BSA (m²)

1.83 ± 0.20

2.00 ± 0.21

1.85 ± 0.20

0.006

0.003

Echocardiographic data

IMM (g/m²)

149 ± 44

86 ± 24

71 ± 15

0.0000001

0.008

ILAVol (ml/m²)

35 ± 12

29 ± 8

28 ± 7

0.04

IVRT (ms)

101 ± 24

96 ± 18

80 ± 16

0.0003

E/A

1.8 ± 0.8

1.2 ± 0.3

1.4 ± 0.4

0.0003

0.03

DT (ms)

198 ± 53

210 ± 56

182 ± 36

0.005

A duration (ms)

113 ± 24

142 ± 26

133 ± 30

0.0003

PV S/D

1.3 ± 0.4

1.3 ± 0.3

1.1 ± 0.3

0.007

PV A’ (cm/s)

0.32 ± 0.07

0.30 ± 0.03

0.30 ± 0.05

A’ duration (ms)

115 ± 34

103 ± 27

93 ± 17

E/e’

6.5 ± 2.0

4.7 ± 1.5

4.1 ± 0.8

0.0008

0.05

**Table 2.** Exercise End Points
	HCM group	AH group	Normal controls
HCM: hypertrophic cardiomyopathy; AH: arterial hypertension
Submaximal heart rate	52%	80%	97%
Fatigue	16%	8%	3%
Hypertensive response	0%	4%	0%
Dyspnea	12%	6%	0%
Drop in systolic blood pressure	8%	0%	0%
Chest pain	8%	0%	0%

Table 2. Exercise End Points

HCM group

AH group

Normal controls

N = 25

N = 34

HCM: hypertrophic cardiomyopathy; AH: arterial hypertension

Submaximal heart rate

52%

80%

97%

Fatigue

16%

Hypertensive response

Dyspnea

12%

Drop in systolic blood pressure

Chest pain

**Table 3.** Echocardiographic Parameters of Diastolic Function After the Stress
	HCM group	AH group	Normal controls	P-value
HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; IVRT: isovolumetric relaxation time; E/A: ratio of the early filling (E) to the late diastolic filling (A) velocities; DT: deceleration time of the early diastolic velocity; PV S/D: ratio of the systolic (S) to early diastolic (D) velocities in the pulmonary vein; PV A’: the late diastolic velocity in the pulmonary vein; E/e’: ratio of the mitral to the annular early diastolic velocities; NS: non-significant difference.
P-value was defined for comparison between HCM and AH groups.
IVRT (ms)	80 ± 20	82 ± 14	66 ± 12	NS
E/A	1.7 ± 0.6	1.1 ± 0.3	1.3 ± 0.3	0.0003
DT (ms)	174 ± 44	184 ± 54	175 ± 32	NS
A duration (ms)	118 ± 25	127 ± 29	134 ± 29	NS
PV S/D	1.2 ± 0.5	1.3 ± 0.3	1.2 ± 0.2	NS
PV A’ (cm/s)	0.34 ± 0.08	0.34 ± 0.04	0.34 ± 0.06	NS
A’ duration (ms)	110 ± 24	100 ± 15	93 ± 17	NS
E/e’	5.9 ± 2.0	4.3 ± 1.4	3.9 ± 0.9	0.007

Table 3. Echocardiographic Parameters of Diastolic Function After the Stress

HCM group

AH group

Normal controls

P-value

N = 25

N = 34

HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; IVRT: isovolumetric relaxation time; E/A: ratio of the early filling (E) to the late diastolic filling (A) velocities; DT: deceleration time of the early diastolic velocity; PV S/D: ratio of the systolic (S) to early diastolic (D) velocities in the pulmonary vein; PV A’: the late diastolic velocity in the pulmonary vein; E/e’: ratio of the mitral to the annular early diastolic velocities; NS: non-significant difference.

P-value was defined for comparison between HCM and AH groups.

IVRT (ms)

80 ± 20

82 ± 14

66 ± 12

E/A

1.7 ± 0.6

1.1 ± 0.3

1.3 ± 0.3

0.0003

DT (ms)

174 ± 44

184 ± 54

175 ± 32

A duration (ms)

118 ± 25

127 ± 29

134 ± 29

PV S/D

1.2 ± 0.5

1.3 ± 0.3

1.2 ± 0.2

PV A’ (cm/s)

0.34 ± 0.08

0.34 ± 0.04

0.34 ± 0.06

A’ duration (ms)

110 ± 24

100 ± 15

93 ± 17

E/e’

5.9 ± 2.0

4.3 ± 1.4

3.9 ± 0.9

0.007

**Table 4.** The Relative Time Parameters
	HCM group	AH group	Normal controls	P-value
HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; TE/R-R: ratio, the time interval between the QRS complex and the onset of mitral early diastolic filling velocity/the time of R-R interval; Te’/R-R: ratio, the interval between the QRS complex and the onset of peak early tissue mitral annular velocity/the time of R-R interval; NS: non-significant difference.
TE/R-R rest	0.49 ± 0.07	0.51 ± 0.07	0.50 ± 0.05	NS
Te’/R-R rest	0.48 ± 0.07	0.48 ± 0.06	0.50 ± 0.05	NS
TE/R-R post stress	0.52 ± 0.05	0.53 ± 0.06	0.53 ± 0.04	NS
Te’/R-R post stress	0.54 ± 0.07	0.49 ± 0.06	0.49 ± 0.06	0.03

Table 4. The Relative Time Parameters

HCM group

AH group

Normal controls

P-value

N = 25

N = 34

HCM: hypertrophic cardiomyopathy; AH: arterial hypertension; TE/R-R: ratio, the time interval between the QRS complex and the onset of mitral early diastolic filling velocity/the time of R-R interval; Te’/R-R: ratio, the interval between the QRS complex and the onset of peak early tissue mitral annular velocity/the time of R-R interval; NS: non-significant difference.

TE/R-R rest

0.49 ± 0.07

0.51 ± 0.07

0.50 ± 0.05

Te’/R-R rest

0.48 ± 0.07

0.48 ± 0.06

0.50 ± 0.05

TE/R-R post stress

0.52 ± 0.05

0.53 ± 0.06

0.53 ± 0.04

Te’/R-R post stress

0.54 ± 0.07

0.49 ± 0.06

0.03