Assessment of left ventricular global systolic strain in hypertrophic cardiomyopathy by three-dimensional speckle tracking echocardiography

Abstract

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI) in evaluating the global systolic strain of left ventricular (LV) in patients with hypertrophic cardiomyopathy (HCM).Methods A total of 90 consecutive patients with HCM were enrolled,in which 58 patients were nonobstructive HCM (HNCM),32 patients were obstructive HCM (HOCM).In addition,72 healthy subjects were recruited as a control group.An ultrasound system iE33 (Philips Medical Systems,Bothell) was used to acquire and analyze two-dimensional images.Full-volume three-dimensional dynamic images were performed using matrix transducer X5-1.LV global longitudinal strain(GLS),global circumferential strain(GCS),global radial longitudinal(GRS),global strain (GS),were analysis using off-line TomTec software,the differences among three groups were compared.Results Compared with the control group,LV end-diastolic,end-systolic volumes and stroke volume significantly decreased,LV mass and LV diastolic wall thickness significanty increased.Howeve,there was no significant difference between LVEF in the HCM and control group (P =0.178).The comparson of the 3D systolic strain in the four groups as followed,compared with the control group,GS was no significant difference,GLS was significantly reduced,however GCS,GRS was significantly increased in HCM groups.When compared with the HNCM,GLS was significant reduced,however GCS,GRS were significant increased in the HOCM group.Bland-Altman analysis showed there were good agreements in both patients with HCM and control subjects.Conclusions 3D-STI can detecte the early impairment of LV global myocardial contractility in HCM,and provides valuable information for clinical in early diagnosis,prevention and treatment. Key words: Echocardiography; Cardiomyopathy, hypertrophic; Ventricular function, left; Three dimensional speckle tracking imaging