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Published on: June 14, 2016

Diastolic myocardial mechanics in hypertrophic cardiomyopathy

Shemy Carasso1, Hua Yang, Anna Woo

  • 1Division of Cardiology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|February 16, 2010
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) impairs left ventricular (LV) relaxation, with reduced longitudinal strain and altered rotation observed. Diastolic dysfunction in HCM correlates with worse functional status and increased left atrial volume.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Medical Imaging

Background:

  • Hypertrophic cardiomyopathy (HCM) involves myocardial hypertrophy, disarray, and fibrosis, impacting cardiac function.
  • Conventional echocardiography has limitations in assessing diastolic function in HCM patients.
  • Understanding left ventricular (LV) relaxation mechanics is crucial for managing HCM.

Purpose of the Study:

  • To determine local and global LV relaxation mechanics in HCM patients.
  • To correlate myocardial mechanics with clinical status and functional class in HCM.
  • To explore the utility of Velocity Vector Imaging in evaluating diastolic dysfunction in HCM.

Main Methods:

  • Seventy-two HCM patients and 32 controls underwent Velocity Vector Imaging.
  • Measured longitudinal and circumferential strain, strain rate, and rotation at LV base, middle, and apex.
  • Analyzed differences between HCM subgroups and controls using ANOVA and post hoc tests.

Main Results:

  • HCM patients showed lower longitudinal strain and systolic/diastolic strain rates, but higher circumferential values.
  • LV untwist was prolonged in all HCM subgroups.
  • Reduced early apical reverse rotation fraction correlated with worse functional status (NYHA class III/IV).
  • Increased left atrial volume paralleled symptom severity and diastolic dysfunction.

Conclusions:

  • Biplane myocardial mechanics evaluation provides novel insights into diastolic function in HCM.
  • Velocity Vector Imaging effectively assesses LV relaxation and its relationship to clinical status in HCM.
  • Findings highlight the importance of advanced imaging for comprehensive HCM assessment.
Abstract

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