Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy

Overview

Journal J Clin Diagn Res

Specialty General Medicine

Date 2015 Feb 6

PMID 25653979

Citations 6

Authors

Ranjan Shetty

Jyothi Samanth

Krishnanand Nayak

Arohi Sarang

Ashok Thakkar

Affiliations

Soon will be listed here.

Abstract

Background: Hypertrophic cardiomyopathy (HCM), an auto-somal dominant disorder due to mutation of genes encoding sarcomeric proteins, leads to left ventricular diastolic dysfunction. Recently, the research in this area suggests that systolic dysfunction exists in the patients with HCM even though traditional measures of systolic dysfunction are normal. So, we carried out this study to determine global systolic dysfunction in patients with HCM.

Materials And Methods: A total of 18 patients, diagnosed with HCM according to echocardiography parameters, that is thickness of interventricular septum/posterior wall thickness >1.3 or hypertrophy involving apex only with or without left ventricular outflow tract obstruction, were included in the study and were compared with normal age-matched controls. We measured torsion and strain imaging by 2-dimensional echocardiography as well as strain imaging by tissue Doppler echocardiography.

Result: The results of the study showed that there was considerable increased torsion in patients with HCM as compared to normal subjects (16.61±7.43 vs. 10.42±4.73, p=0.006). Tissue Doppler indices-systolic annular velocity (7.7±0.7 vs. 8.7±1.00, p=0.012) and lateral wall E/E' (12.52±5.27 vs. 6.66±1.67, p<0.001) were significantly different in patients with HCM and normal subjects. The average systolic strain and strain rate as well as diastolic strain rate were significantly different in both the groups when strain imaging was performed by tissue Doppler echocardiography. We also observed significantly reduced global longitudinal, circumferential and radial strain in patients with HCM when strain analysis was carried out with 2-dimensional speckle tracking echocardiography.

Conclusion: The global subtle systolic dysfunction, as measured by left ventricular torsion and strain imaging, is present in patients with HCM even though traditional measure of systolic dysfunction is normal.

Citing Articles

Evaluation the relationship between myocardial fibrosis and left ventricular torsion measured by cardiac magnetic resonance feature-tracking in hypertrophic cardiomyopathy patients with preserved ejection fraction.

Zhong Y, Li C, Yu Y, Du Y, Bai Y, Wang X Int J Cardiovasc Imaging. 2024; 40(4):921-930.

PMID: 38448705 DOI: 10.1007/s10554-024-03061-7.

Novel Hypertrophic Cardiomyopathy Diagnosis Index Using Deep Features and Local Directional Pattern Techniques.

Gudigar A, Raghavendra U, Samanth J, Dharmik C, Gangavarapu M, Nayak K J Imaging. 2022; 8(4).

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Critical Evaluation of Current Hypotheses for the Pathogenesis of Hypertrophic Cardiomyopathy.

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Could two-dimensional radial strain be considered as a novel tool to identify pre-clinical hypertrophic cardiomyopathy mutation carriers?.

Santambrogio G, Maloberti A, Vallerio P, Peritore A, Spano F, Occhi L Int J Cardiovasc Imaging. 2019; 35(12):2167-2175.

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Strain Imaging Echocardiography: What Imaging Cardiologists Should Know.

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