Clinical value of carotid wave intensity analysis for differentiating nonobstructive hypertrophic cardiomyopathy from left ventricular hypertrophy secondary to systemic hypertension

Purpose. Wave intensity (WI) is a set of new hemodynamic indexes (W1, W2, and NA) based on the calculation of (dp/dt) × (dv/dt) on any artery. We assessed the value of carotid WI analysis for differentiating nonobstructive hypertrophic cardiomyopathy (NOHCM) from left ventricular hypertrophy secondary to hypertension (LVHSH). Methods. Nineteen NOHCM, 34 LVHSH, and 37 normal controls (NC) underwent conventional echocardiographic examination and carotid WI analysis performed with an Aloka α10 sonographic system (Alok, Tokyo, Japan) with real-time wave intensity calculation software. Results. W1 was higher in NOHCM (11,830 ± 7,850 mmHg·m·s−3) and in LVHSH (13,670 ± 13,490 mmHg·m·s−3) than in NC (7,010 ± 3,620 mmHg·m·s−3). W2 was lower in NOHCM (850 ± 870 mmHg·m·s−3) than in LVHSH (2,310 ± 1,390 mmHg·m·s−3, p < 0.01) and in NC (1,650 ± 960 mmHg·m·s−3, p < 0.01). Using W2 ≤ 1,100 mmHg·m·s−3 as a threshold for differentiating NOHCM from LVHSH yielded an 84.2% sensitivity and 82.4% specificity. NA was higher in LVHSH (57.55 ± 57.82 mmHg·m·s−2) than in NOHCM (34.24 ± 13.03 mmHg·m·s−2, p < 0.05) and in NC (31.67 ± 23.05 mmHg·m·s−2, p < 0.05). Using NA ≤40 mmHg·m·s−2 as a threshold for differentiating NOHCM from LVHSH yielded a 63.2% sensitivity and 70.6% specificity. Conclusions. W2 and NA indexes derived from carotid WI analysis may be helpful for differentiating NOHCM from LVHSH. © 2012 Wiley Periodicals, Inc. J Clin Ultrasound, 2013