Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy
Background: Hypertrophic cardiomyopathy (HCM), an autosomal 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...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2014-12-01
|
Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/5287/10185_CE(NJ)_F(Sh)_PF1(NJAK)_PFA(Sh).pdf |
Summary: | Background: Hypertrophic cardiomyopathy (HCM), an autosomal 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. |
---|---|
ISSN: | 2249-782X 0973-709X |