[Role of Doppler echocardiography in the diagnostics and therapy of hypertrophic cardiomyopathy]

Abstract

Hypertrophic cardiomyopathy (HCM) is a complex and relatively common genetic heart disease. HCM is caused by mutations of genes encoding sarcomeric contractile proteins and it is characterized by heterogeneous pattern of left ventricular hypertrophy with dynamic obstruction of left ventricular outflow tract. HCM is associated with both impaired left ventricular contractility and diastolic function. Using Doppler echocardiography, we are able to assess left ventricular diastolic function and measure left ventricular outflow gradient. Tissue Doppler imaging of mitral annulus is able to discriminate genotype-positive patients which allows us to improve diagnostic sensitivity of echocardiography. The Tei index is a new Doppler index, combining systolic and diastolic time intervals as an expression of global myocardial performance ("index of myocardial performance"). Non-pharmacologic treatment of obstructive HCM (alcohol septal ablation) is associated with improvement of Tei index. Doppler echocardiography is an indispensable tool in the management of HCM.