Impact of segmental hypertrophy on global and regional left ventricular deformation in hypertrophic cardiomyopathy A 3D speckle tracking imaging study

Abstract

To assess left ventricular (LV) myocardial deformation with 3D echocardiography in hypertrophic cardiomyopathy (HCM) and study the impact of hypertrophy on global and regional systolic deformation. Forty HCM and 114 control patients with comprehensive 2D and 3D resting echocardiography (GE Vivid 9). Secondary HCM excluded classification of segments in relation to wall thickness in 2D short-axis views (30 patients) [as first quartile (< 10.5 mm, n = 104), third quartile (13.0–16.5ϖsecond quartile (10.5–13.0 mm, n = 103) mm, n = 101) and fourth quartile (> 16.5 mm, n = 106)]. All 3D strain value significantly decreased from 2nd to 4th quartile of myocardial thickness. Compared to control subjects, strain values were significantly lower: – in all quartiles of myocardial thickness for 3DGLS and 3DGAS, – in 3rd and 4th quartiles for 3DGRS, – 3DGCS in absolute value was increased for non hypertrophic segments (1st and 2nd quartiles) and decreased for 4th quartile. In addition, post-systolic shortening is frequent with higher values in 4th quartile of myocardial thickness ( Fig. 1 ). 3D echocardiography is a useful tool in HCM patients, allowing the analysis of all global and regional deformation parameters in one acquisition. Hypertrophy has an impact on the global mechanics of LV and on regional deformation of hypertrophic segments. Whatever the myocardial thickness, longitudinal strain absolute value is decreased. On another hand, circumferential strain is increased in non hypertrophic segments (1st and 2nd quartiles). Conversely, severely hypertrophic segments exhibits altered values for all strain components and higher value of post systolic index.