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Echocardiographic strain in hypertrophic cardiomyopathy and hypertensive left ventricular hypertrophy

Jing-Ping Sun1,2, Ting-Yan Xu1, Xian-Da Ni3

  • 1State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Hypertension, Center for Vascular Evaluations, The Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.

Echocardiography (Mount Kisco, N.Y.)
|December 19, 2018
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) shows reduced myocardial strain compared to hypertensive left ventricular hypertrophy (LVH). Multilayer strain analysis can differentiate these conditions, aiding diagnosis.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biophysics

Background:

  • Myocardial structure varies between hypertrophic cardiomyopathy (HCM) and secondary left ventricular hypertrophy (LVH).
  • Differentiating these conditions is crucial for appropriate patient management.
  • Two-dimensional echocardiography with multilayer strain analysis offers a potential method for assessment.

Purpose of the Study:

  • To investigate and compare left ventricular function in patients with HCM and hypertensive LVH.
  • To utilize multilayer strain analysis to identify distinct patterns in these two conditions.
  • To assess the utility of endo-/epi-myocardial strain ratios in differentiating HCM from hypertensive LVH.

Main Methods:

  • Transthoracic echocardiography was performed on 240 patients: 80 with HCM, 80 with hypertensive LVH, and 80 controls.
  • Quantitative multilayer longitudinal strain (LS), circumferential strain (CS), and radial strain (RS) were analyzed.
  • The ratio of endocardial to epicardial strain was calculated for LS and CS.

Main Results:

  • HCM patients exhibited significantly lower LS and CS compared to controls and hypertensive LVH patients.
  • Hypertensive LVH patients showed reduced LS but preserved CS across all myocardial layers.
  • Increased endo-/epi-myocardial ratios of LS and CS were observed in HCM compared to hypertensive LVH.
  • Radial strain (RS) was higher in HCM patients than in hypertensive LVH and controls.

Conclusions:

  • Hypertrophic cardiomyopathy is characterized by marked reductions in longitudinal and circumferential strain.
  • Hypertensive LVH demonstrates less pronounced longitudinal strain reduction and preserved circumferential strain.
  • Endo-/epi-myocardial strain ratios are valuable quantitative markers for differentiating HCM from hypertensive LVH.
Abstract

Keywords:
hypertensive left ventricular hypertrophyhypertrophic cardiomyopathyleft ventricular functiontwo-dimensional strain

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