Right ventricular mechanics in hypertrophic cardiomyopathy using feature tracking

Area of Science:

• Cardiology
• Cardiovascular Imaging
• Biomedical Engineering

Background:

• Right ventricular (RV) mechanics in hypertrophic cardiomyopathy (HCM) are not well understood.
• Assessing RV function is crucial for understanding HCM pathophysiology and patient outcomes.
• 2D strain vector velocity imaging (VVI) offers a potential method for detailed RV analysis.

Purpose of the Study:

• To investigate global and regional RV deformation in HCM patients using VVI.
• To explore the relationship between RV mechanics and the left ventricular (LV) phenotype in HCM.
• To identify predictors of RV dysfunction in HCM.

Main Methods:

• 100 HCM patients and 30 controls underwent VVI analysis.
• Quantified longitudinal peak systolic strain (ϵsys), strain rate (SR), and time to peak (TTP) for both RV and LV segments.
• Analyzed RV free wall (RVFW) and septal wall displacement; calculated intra- and inter-ventricular delays.

Main Results:

• HCM patients showed a significant decline in RV and LV ϵsys and SR, with a loss of the base-to-apex gradient.
• RVFW deformation parameters strongly correlated with each other and were linked to LV mechanics and HCM severity markers.
• RVFW displacement and global LV SRsys were identified as independent predictors of global RV deformation.

Conclusions:

• RV deformation is demonstrably impaired in HCM, as assessed by feature tracking.
• RV mechanics are independently influenced by LV function and correlate with the severity of the LV phenotype.
• RVFW deformation analysis provides comparable information to global RV assessment in HCM.