Right ventricular function in hypertrophic cardiomyopathy: A speckle tracking echocardiography study

Area of Science:

• Cardiology
• Echocardiography
• Cardiovascular Imaging

Background:

• Hypertrophic cardiomyopathy (HCM) is a genetic heart disease characterized by left ventricular hypertrophy.
• Right ventricular (RV) involvement in HCM is increasingly recognized but not fully understood.
• Assessing RV mechanical function is crucial for risk stratification and management in HCM.

Purpose of the Study:

• To evaluate RV mechanical function in patients with HCM using 2-D speckle tracking echocardiography (2-D-STE).
• To compare RV and left ventricular (LV) function between HCM patients and healthy controls.
• To investigate the impact of left ventricular outflow tract (LVOT) obstruction on RV function in HCM.

Main Methods:

• A cross-sectional study included 43 HCM patients and 40 healthy controls.
• 2-D speckle tracking echocardiography (2-D-STE) and tissue Doppler imaging (TDI) were used to assess RV and LV function.
• HCM patients were stratified based on LVOT gradient (ACC/ESC guidelines).
• Statistical analysis included Student t-test and Mann-Whitney U tests.

Main Results:

• HCM patients exhibited larger right atrium and RV diameters and higher mean pulmonary artery pressures (mPAP) compared to controls.
• RV strain measurements were significantly lower in HCM patients, indicating impaired RV systolic function.
• Significant differences in LV global longitudinal, radial, and circumferential strain were observed.
• Mid-ventricular LV rotation was more clockwise in HCM patients.
• Higher mPAP was noted in HCM patients with significant LVOT obstruction, but other RV parameters were not significantly affected.

Conclusions:

• 2-D-STE reveals impaired RV systolic function in HCM patients compared to healthy individuals.
• RV systolic function in HCM is not significantly influenced by LVOT obstruction.
• Left ventricular rotation dynamics are altered in HCM patients.