Hypertrophic Cardiomyopathy Is Associated with Abnormal Echocardiographic Aortic Elastic Properties and Arteriograph-Derived Pulse-Wave Velocity

Objective: Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disease and defined by the presence of unexplained left ventricular hypertrophy (LVH). Vascular alterations are frequently associated with HCM including microvascular and/or peripherial endothelial dysfunction. This study was designed to evaluate echocardiographic ascending aortic elastic properties and arteriograph-derived pulse-wave velocity (PWV) and augmentation index (Aix) in HCM. Methods: This study comprised 38 patients with typical features of HCM. Their results were compared to 20 hypertensive patients with LVH and 23 controls. Systolic and diastolic ascending aortic diameters were recorded in M-mode at a level of 3 cm above the aortic valve from a parasternal long-axis view. The following echocardiographic aortic elastic properties were measured from aortic data and forearm blood pressure values: aortic strain, distensibility, and stiffness index. Arteriograph-derived PWV and AIx were also measured. Results: Aortic stiffness index (18.4 +/- 17.6 vs. 6.88 +/- 3.63, P < 0.05), PWV (9.44 +/- 4.08 vs. 7.97 +/- 1.20 m/sec, P < 0.05) and Aix (-24.9 +/- 32.6 vs. -41.4 +/- 24.3, P < 0.05) were increased, while aortic strain (0.061 +/- 0.053 vs. 0.100 +/- 0.059, P < 0.05) and aortic distensibility (1.94 +/- 1.68 cm(2)/dynes 10(-6) vs. 3.08 +/- 1.77 cm(2)/dynes 10(-6), P < 0.05) were decreased in HCM patients compared to controls. Aortic elastic properties of hypertensive patients with LVH showed similar alterations to HCM patients. Conclusions: Abnormal echocardiographic aortic elastic properties and arteriograph-derived PWV and Aix could be demonstrated in HCM patients compared to matched controls. (Echocardiography 2011;28:848-852)