Open AccessClinical significance of early diastolic time intervals for the differentiation of idiopathic dilative cardiomyopathy from ischemic cardiomyopathy
Author(s) -
Sekiya M.,
Hamada M.,
Kokubu T.
Publication year - 1987
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960100602
Subject(s) - medicine , cardiology , cardiomyopathy , ischemic cardiomyopathy , diastole , blood pressure , heart failure , ejection fraction
In order to differentiate idiopathic dilative cardiomyopathy from ischemic çardiomyopathy noninvasively, systolic time intervals (STIs) and early diastolic time intervals were investigated in patients with idiopathic dilative cardiomyopathy (n = 11), patients with ischemic cardiomyopathy (n = 8), and normal controls (n = 17). Minimal left ventricular pressure and pulmonary capillary wedge pressure (PCWP) were also measured to clarify the relationship between early diastolic time intervals and early diastolic hemodynamics. Cardiac function estimated by STIs was markedly depressed both in idiopathic dilative cardiomyopathy and ischemic cardiomyopathy, and there was no difference between the two diseases. In early diastolic time intervals, IIA‐O time (the interval from the aortic component of the second heart sound to the O point of apexcardiogram) was significantly prolonged both in idiopathic dilative cardiomyopathy (144±31 (SD); p<0.01) and ischemic cardiomyopathy (153±15; p<0.01) compared to normal controls (126±11). IIA‐MVO time (the interval from IIA to the mitral valve opening) in idiopathic dilative cardiomyopathy (49±23) was significantly shorter than that in normal controls (70±8; p<0.05). On the contrary, IIA‐MVO time in ischemic cardiomyopathy (126±11) was markedly prolonged compared with normal controls (p<0.01) and idiopathic dilative cardiomyopathy (p<0.01). MVO‐O time was significantly prolonged in idiopathic dilative cardiomyopathy (94±18; p<0.01). However, it was conversely shortened in ischemic cardiomyopathy (25±15) compared with normal controls (54±7; p<0.01). Minimal left ventricular pressure in ischemic cardiomyopathy was significantly higher than that in idiopathic dilative cardiomyopathy and normal controls (each p<0.05). PCWP in idiopathic dilative cardiomyopathy was relatively higher than that in ischemic cardiomyopathy. The smaller value of pressure difference between PCWP and minimal left ventricular pressure in ischemic cardiomyopathy might contribute to the shortening of MVO‐O time. The different characteristics of early diastolic time intervals in idiopathic dilative cardiomyopathy and ischemic cardiomyopathy are of important diagnostic value in differentiating idiopathic dilative cardiomyopathy from ischemic cardiomyopathy noninvasively.