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Layer-specific strain analysis of left ventricular myocardium after alcohol septal ablation for hypertrophic

Juan Zhang1, Linlin Zhu, Xiaomin Jiang

  • 1Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu Province, China.

Medicine
|November 9, 2018
PubMed

Insights

Hypertrophic obstructive cardiomyopathy (HOCM) shows decreased myocardial strain. Alcohol septal ablation (ASA) improved left ventricular (LV) endocardial strain in the basal septum, indicating recovery.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Myocardial Mechanics

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) is characterized by impaired left ventricular (LV) function.
  • Layer-specific myocardial strain analysis offers insights into regional cardiac mechanics.

Purpose of the Study:

  • To investigate layer-specific systolic strain in the LV myocardium of HOCM patients before and after alcohol septal ablation (ASA).
  • To assess changes in myocardial strain patterns following ASA treatment.

Main Methods:

  • Utilized routine 2D echocardiography (frame rate >50 Hz) and speckle tracking analysis.
  • Acquired data from 44 HOCM patients and 21 normal subjects, with serial echocardiograms for 15 HOCM patients post-ASA.
  • Analyzed layer strain using EchoPAC software.

Main Results:

  • Layer strain declined from inner to outer myocardial layers in basal and middle segments of HOCM patients.
  • Absolute peak systolic strains were significantly lower in the basal septum of HOCM patients compared to controls (P<.01).
  • LV endocardial strain in the basal septum significantly increased 1 year after ASA (P<.05).

Conclusions:

  • Layer-specific myocardial strains are significantly reduced in HOCM patients compared to healthy individuals.
  • Increased specific layer strain of the LV endocardium in the basal septum serves as a marker for echocardiographic improvement after ASA in HOCM.
Abstract

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