Document Detail


Investigation of Global and Regional Myocardial Mechanics with 3D Speckle Tracking Echocardiography and Relations to Hypertrophy and Fibrosis in Hypertrophic Cardiomyopathy.
MedLine Citation:
PMID:  24275954     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -In hypertrophic cardiomyopathy (HCM), heterogeneous myocardial hypertrophy and fibrosis are responsible for abnormalities of left ventricular (LV) function. We aimed to characterize LV global and regional myocardial mechanics in HCM, according to segmental hypertrophy and fibrosis.
METHODS AND RESULTS: -Fifty-nine patients with HCM underwent standard echocardiography, 3D speckle tracking echocardiography (STE) and cardiac magnetic resonance with late gadolinium enhancement (LGE), all 3 tests less than 24h apart. Longitudinal (LSt), circumferential (CSt) and area strains were investigated according to the extent of LGE (no LGE, LGE<10%, and LGE≥10%), segmental thickness (≥15mm vs. <15mm) and segmental LGE (LGE vs. non-LGE). Attenuated global LSt showed association with extent of hypertrophy (indexed LV mass, r=0.32, p=0.01; maximum LV wall thickness, r=0.34, p=0.009; number of segments ≥15mm, r=0.44, p<0.001), while enhanced global CSt was correlated to LV global functional parameters (indexed end-systolic volume, r=0.47, p<0.001; ejection fraction, r=-0.75, p<0.001). Parameters of global myocardial mechanics showed no association with the extent of LGE; in contrast, the extent of LGE was associated with extent of hypertrophy. All 3 deformation parameters were attenuated both in segments ≥15mm in thickness and in those with LGE; adjusted analysis demonstrated that segmental presence of LGE was associated with additional attenuation in myocardial deformation.
CONCLUSIONS: -Both hypertrophy and fibrosis contribute to regional impairment of myocardial shortening in HCM. The extent of hypertrophy is the primary factor altering global myocardial mechanics. Circumferential myocardial shortening seems to be directly involved in preservation of LV systolic performance in HCM.
Authors:
Jose Angel Urbano-Moral; Ethan J Rowin; Martin S Maron; Andrew Crean; Natesa G Pandian
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-11-25
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Hypertrophic Cardiomyopathy Center and Cardiovascular Imaging and Hemodynamic Laboratory, Tufts Medical Center, Boston, MA.
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