The Role of Presystolic A Wave in the Differentiation of Non-obstructive
Hypertrophic Cardiomyopathy and Athlete's Heart
Abstract
Background: Even though hypertrophic cardiomyopathy (HCM) can be
distinguished from the athlete’s heart with a difference in
echocardiographic measurements, difficulties may be encountered in
clinical practice from time to time. The aim of this study was to
evaluate the use of presystolic A wave (PSAW) assessed by the Doppler
echocardiography for differentiating between HCM and athlete’s heart.
Methods: A total of 52 subjects were included in the present study, of
which, 27 had HCM and 25 were athletes. The pulsed Doppler assessment of
the left ventricular outflow tract was performed on the ventricular face
from the immediate proximal of the aortic valve on the apical
five-chamber view. Allpatients were assessed for the presence of
PSAW,and the velocity of this wave was recordedin PSAW positive
subjects. Results: The frequency of PSAW was found to be higher in
patients with HCM [n = 12 (44%)] than in athletes [n = 4
(16%)] (p = 0.026). PSAW velocity measurements were observed to be
higher in the HCM group; however, there was no statistical significance
[53 ms (36–84)], [68 ms (35–193)], (p = 0.362). Conclusion:
While there is a need for scaling-up similar studies, the current
findings suggest that PSAW can be used as a distinguishing parameter for
differentiating HCM and athlete’s heart.