Clinical study on LVO-based evaluation of left ventricular wall thickness and volume of AHCM patients

Abstract

ObjectiveThe aim of this study is to evaluate the clinical value of left ventricular opacification (LVO) in detecting left ventricular wall thickness (LVWT) and left ventricular (LV)volume in patients with apical hypertrophic cardiomyopathy (AHCM). MethodsConventional two-dimensional echocardiography (2DE) and LVO dynamic images of apical four-chamber (AP4C), apical two-chamber(AP2C), and short axis views of the basal, middle, and apical segments were collected from 27 AHCM patients and 33 normal subjects. LVWT（including 16 segments at 3 different levels）and LV volume were measured by both 2DE and LVO, compared between the two groups. Results(1) LVWT of the middle and the apical segments were higher in the AHCM than those in the control group measured by both LVO and 2DE (P < 0.001). (2) LVWT at the basal, middle and apical segments measured by LVO in the two groups were lower than those by 2DE, (P < 0.001). In the control group, the LVWT decreased from the basal to the apical segment, while in the AHCM group, the LVWT increased from the base to the apex,(P < 0.001).(3)LVEDV, LVESV, SV obtained by LVO were higher.than those by 2DE in the two groups (P < 0.001). LVEDV, LVESV and SV in the AHCM group were lower compared to the control group(P < 0.001).(4)The intra-observer repeatability of LVWT and LV volum in AHCM patients measured by LVO were higher than those by 2DE(P < 0.001). Conclusion(1)LVO can improve the delineation of the endocardial border, enabling more accurate diagnosis of AHCM than by 2DE. (2) LVO can improve display of the LV apical structure, leading to more accurate evaluation of LVWT, and LV volume, than by 2DE, in patients with AHCM; potentially providing more reliable information for clinical diagnosis and treatment and meriting wider clinical application.