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Hypertrophic cardiomyopathy is associated with more severe left ventricular dyssynchrony than is hypertensive left

Toshiki Nagakura1, Masaaki Takeuchi, Hidetoshi Yoshitani

  • 1Department of Cardiology and Internal Medicine, Tane General Hospital, Osaka, Japan.

Echocardiography (Mount Kisco, N.Y.)
|July 27, 2007
PubMed

Insights

Left ventricular hypertrophy (LVH) can cause left ventricular (LV) dyssynchrony. Hypertrophic cardiomyopathy (HCM) patients show more severe LV dyssynchrony than hypertensive heart disease (HHD) patients, potentially worsening cardiovascular outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Left ventricular hypertrophy (LVH) is a common cardiac condition.
  • Distinguishing between hypertrophic cardiomyopathy (HCM) and hypertensive heart disease (HHD) is crucial for patient management.
  • Left ventricular (LV) dyssynchrony may play a role in the pathophysiology of LVH.

Purpose of the Study:

  • To evaluate left ventricular (LV) dyssynchrony in patients with LVH.
  • To compare LV dyssynchrony in patients with HCM versus HHD.
  • To utilize 2D speckle tracking imaging (STI) for assessing these abnormalities.

Main Methods:

  • Acquired 2D LV short-axis images in 43 LVH patients (20 HCM, 23 HHD) and 15 controls.
  • Measured radial and circumferential strain, and time to peak strain (Trs, Tcs) using 2D STI.
  • Calculated LV dyssynchrony using the standard deviation of Trs/Tcs in 18 segments (Trs-18SD, Tcs-18SD).

Main Results:

  • Regional strain was reduced in HCM compared to HHD, particularly in apical segments.
  • LV dyssynchrony, measured by Trs-18SD and Tcs-18SD, was significantly longer in HCM patients.
  • HCM patients exhibited more severe LV dyssynchrony (Trs-18SD: 88±32 ms, Tcs-18SD: 71±27 ms) than HHD (51±20 ms, 46±14 ms) and controls (45±12 ms, 45±14 ms).

Conclusions:

  • LVH is not always associated with LV dyssynchrony.
  • Severe LV dyssynchrony is characteristic of HCM.
  • Increased LV dyssynchrony in HCM may contribute to adverse cardiovascular outcomes.
Abstract

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