Abstract 11644: Differentiating Hypertrophic Cardiomyopathy From Hypertensive Left Ventricular Hypertrophy Using Quantitative Layer-specific Speckle-tracking Echocardiography

Abstract

Background: The distinction of mild to moderate hypertrophic cardiomyopathy (HCM) from hypertensive left ventricular hypertrophy (HLVH) may be difficult. The aim of this study was to determine the value of a novel multi-layer transthoracic echocardiography in differential diagnosis between HCM and HLVH. Methods: Sixty eight patients with HCM and preserved LV ejection fraction (82% male, 50±14 years; LVEF 64±8%); age and sex matched with 68 HLVH (56 male; 50±13 years, LVEF 64±8%) and 68 controls (56 male,50±13 years; LVEF 65±6%) underwent STE (GE Vivid-E9). Quantitative layer-specific longitudinal (LS), circumferential (CS) endocardium, mid-myocardium, and epicardium strain as well as radial strain (RS) assessed by 2-dimensional strain echocardiography. Ratios of endo- to epicardium (end/epi) strain were calculated. Results: The absolute value of LS on all layers of hypertrophic segments (Fig. showing LS was normal only in normal thickness of posterior and apical wall) were significantly less but the ratio of end/epi strain and RS were significantly greater in HCM than in HLVH and control group (p< 0.0001 for all, Table). The LS measurements of all LV segments was less but endocardial CS was greater in HLVH than control and HCM; LV global LS and CS was significantly less in HCM patients than HLVH and controls. Conclusions: Regional variations of strain and higher ratio of end-/epi-myocardial strain can be used to differentiate diagnosis between HCM and HLVH. The higher value of endo-circumferential strain of patients with HLVH and radial strain of patients with HCM might be the complemental mechanism to reserve the normal LVEF.