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Abnormal left ventricular contraction sequence in hypertrophic cardiomyopathy patients: first description of

Josselin Duchateau1, Claire Cornolle1, Jérome Peyrou1

  • 1Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.

Ultrasound in Medicine & Biology
|March 10, 2015
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) alters the normal sequence of left ventricular contraction, causing a loss of the apex-to-base delay (ABD) essential for efficient heart function. This change in cardiac mechanics is independent of other clinical factors.

Area of Science:

  • Cardiology
  • Biomedical Engineering
  • Cardiac Physiology

Background:

  • Normal left ventricular contraction exhibits an apex-to-base delay (ABD), a form of physiologic asynchrony crucial for efficient cardiac mechanics.
  • Hypertrophic cardiomyopathy (HCM) is a condition affecting the heart muscle, potentially altering its contraction patterns.

Purpose of the Study:

  • To compare the left ventricular contraction sequence in patients with HCM and healthy individuals.
  • To investigate the presence and significance of apex-to-base delay (ABD) in HCM patients.

Main Methods:

  • Prospective analysis of echocardiographic data from 40 HCM patients and 20 healthy controls.
  • Measurement of endocardial longitudinal and circumferential strains and ABD using custom software.
  • Statistical comparison of strain parameters and ABD between HCM patients and controls.

Main Results:

  • HCM patients demonstrated increased circumferential strain and decreased longitudinal strain compared to controls.
  • Physiologic ABD was observed in healthy controls (35.7 ± 18.1 ms).
  • HCM patients showed a significantly reduced ABD (5.5 ± 22.7 ms) compared to controls, indicating a loss of normal contraction sequencing.

Conclusions:

  • Left ventricular contraction sequence is modified in HCM patients, characterized by the loss of physiologic apex-to-base delay.
  • The observed alteration in contraction sequence in HCM is independent of commonly measured clinical and echocardiographic parameters.

Keywords:
CardiomyopathyEchocardiographyHypertrophyMechanicsMyocardial contraction

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