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Myocardial fibrosis is associated with biventricular dysfunction in patients with hypertrophic cardiomyopathy

Christian Prinz1, Frank van Buuren, Lothar Faber

  • 1Department of Cardiology, Heart and Diabetes Centre North Rhine-Westphalia, University Hospital of the Ruhr University Bochum, Bad Oeynhausen, Germany. Cchrprinz@aol.com

Echocardiography (Mount Kisco, N.Y.)
|December 14, 2011
PubMed

Insights

Two-dimensional speckle tracking echocardiography reveals that myocardial fibrosis in hypertrophic cardiomyopathy (HCM) is linked to impaired left and right ventricular (LV and RV) function. This imaging technique is effective for assessing both LV and RV dysfunction in HCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Hypertrophic cardiomyopathy (HCM) is a primary cardiac disease affecting the left ventricle (LV).
  • The extent and impact of right ventricular (RV) involvement in HCM, particularly concerning myocardial fibrosis, require further investigation.
  • Assessing global and regional ventricular function is crucial for understanding HCM pathophysiology and patient outcomes.

Purpose of the Study:

  • To evaluate left (LV) and right ventricular (RV) function using 2D speckle tracking echocardiography (STE).
  • To determine the relationship between myocardial fibrosis, detected by cardiac magnetic resonance imaging (MRI), and ventricular dysfunction in HCM patients.
  • To assess the feasibility of STE for evaluating biventricular function in HCM.

Main Methods:

  • Fifty patients diagnosed with HCM underwent echocardiography using high-end scanners.
  • Two-dimensional speckle tracking echocardiography (STE) software was utilized for LV and RV function analysis.
  • Cardiac magnetic resonance imaging (MRI) with late gadolinium enhancement (LGE) was performed to detect myocardial fibrosis.

Main Results:

  • Sixty percent of HCM patients showed LV LGE on MRI; only 7% had RV LGE.
  • HCM patients with myocardial fibrosis exhibited reduced global longitudinal LV strain compared to those without fibrosis (-12.8 ± 2.2 vs -21.1 ± 2.6, P < 0.001).
  • Fibrosis was associated with increased interventricular septum thickness, larger left atria, impaired diastolic function, and comparable RV dysfunction. LV and RV strain showed a strong correlation (r = 0.85, P < 0.001).

Conclusions:

  • Hypertrophic cardiomyopathy affects both the left and right ventricles.
  • Myocardial fibrosis, indicated by LGE, is associated with biventricular dysfunction in HCM.
  • Two-dimensional speckle tracking echocardiography is a viable method for assessing LV and RV dysfunction in HCM patients, even in the presence of fibrosis.
Abstract

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