Reduction of left ventricular longitudinal global and segmental systolic functions in patients with hypertrophic cardiomyopathy: Study of two-dimensional tissue motion annular displacement.

Liwen Liu,Fang Liu,Yandan Sun,Shuping Ge,Hong Shao,Lili Hao,Liping Yang,Xiaodong Zhou,Shengjun Tuo,Wei Qi,Jianlei Zhang,Lei Zuo

doi:10.3892/etm.2014.1617

Abstract

The early detection of abnormal left ventricular systolic functions in patients with hypertrophic cardiomyopathy (HCM) remains a challenge. The aim of this study was to identify a novel method for the assessment of left ventricular systolic function in patients with HCM. A total of 65 patients with HCM were included in this study. The patients were divided into obstructive HCM (HOCM; 16 cases) and non-obstructive HCM (NOHCM; 49 cases) groups. The healthy control group comprised 48 participants. Two-dimensional (2D) speckle-tracking technology was used to measure the left ventricular global and segmental longitudinal strains and mitral annular displacement (MADs). Compared with healthy control group, the six segmental strains and the global strain of the left ventricle (LSglobal) increased while six segmental MADs and MADglobal of the mitral annulus decreased in the HOCM and NOHCM groups (P<0.05). In addition, the six segmental MADs of the mitral annulus were significantly negatively correlated with the six segmental strains of the left ventricle (r=−0.744 to −0.647, P<0.001). MADglobal was significantly negatively correlated with LSglobal (r=−0.857, P<0.001). The tissue motion annular displacement (TMAD) at the midpoint was significantly negatively correlated with LSglobal (r=−0.871, P<0.001). The 2D TMAD technique of measuring MAD was feasible and practically approachable for rapidly evaluating the left ventricular longitudinal global and segmental systolic functions of patients with HCM.

Highlights

Modern molecular biological studies have confirmed that hypertrophic cardiomyopathy (HCM) is an autosomal dominant genetic disease caused by the genetic mutation of the myocardial sarcomere gene [1,2,3,4], and it has an incidence rate of ~1/500 [5,6]
No significant differences were identified in the ejection fraction (EF), left ventricular end-systolic volume (LVESV) and left ventricular internal diameter at end diastole (LVIDd) among the three groups (Table II)
tissue motion annular displacement (TMAD) technology was used in the present study to evaluate the left ventricular longitudinal systolic functions of patients with HCM

Summary

Introduction

Modern molecular biological studies have confirmed that hypertrophic cardiomyopathy (HCM) is an autosomal dominant genetic disease caused by the genetic mutation of the myocardial sarcomere gene [1,2,3,4], and it has an incidence rate of ~1/500 [5,6]. The examination of the left ventricular functions is important for patients with HCM, in the evaluation of treatment efficacy and long‐term follow‐up. The conventional view considers that cardiac involvement is common with HCM and represents as left ventricular diastolic dysfunction [8,9,10,11]. Molecular studies have identified that in HCM, the disorder of systolic function occurs initially and the cardiac hypertrophy is a compensatory response [12,13]. Sufficient evidence indicates that despite the reductions of left ventricular systolic functions in patients with HCM [14,15], such as significant reductions in the left ventricular strain and strain rate, the left ventricular ejection fraction (LVEF) of the majority of patients remains normal or enhanced [16]. The use of LVEF to evaluate the global left ventricular systolic functions is not able to truly reflect the impaired condition of the left ventricular systolic functions

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Conclusion