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Delayed left ventricular untwisting in hypertrophic cardiomyopathy

Bas M van Dalen1, Floris Kauer, Michelle Michels

  • 1Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|October 10, 2009
PubMed

Insights

Left ventricular (LV) untwisting is delayed in hypertrophic cardiomyopathy (HCM) patients, contributing to diastolic dysfunction. This study assessed LV untwisting using speckle-tracking echocardiography in HCM patients and controls.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) frequently involves left ventricular (LV) diastolic dysfunction, though its mechanisms are not fully understood.
  • Targeting the root causes of LV diastolic dysfunction is crucial for effective therapeutic strategies.
  • Assessing LV diastolic untwisting may offer insights into the mechanisms of diastolic dysfunction.

Purpose of the Study:

  • To investigate and characterize left ventricular (LV) untwisting patterns in patients with hypertrophic cardiomyopathy (HCM).
  • To compare LV untwisting parameters between HCM patients and healthy control subjects.

Main Methods:

  • Speckle-tracking echocardiography was employed to assess LV untwisting parameters.
  • The study included 75 consecutive patients diagnosed with HCM and 75 age- and sex-matched healthy control subjects.

Main Results:

  • Patients with HCM exhibited significantly lower untwisting at 5%, 10%, and 15% of diastole compared to controls (P < .001).
  • Key parameters like peak diastolic untwisting velocity and untwisting rate from peak systolic twist to mitral valve opening were reduced in HCM patients (P < .05 and P < .01, respectively).
  • Time-to-peak diastolic untwisting velocity was prolonged in HCM, and untwisting rates correlated with diastolic dysfunction severity.

Conclusions:

  • Left ventricular (LV) untwisting is demonstrably delayed in patients with hypertrophic cardiomyopathy (HCM).
  • This delay in LV untwisting is a likely significant contributor to the observed diastolic dysfunction in HCM.
Abstract

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