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Left ventricular long-axis function in hypertrophic cardiomyopathy - Relationships between e`, early diastolic
Roger E Peverill1, Bon Chou1, Lesley Donelan1
1Monash Cardiovascular Research Centre, MonashHeart and Department of Medicine, School of Clinical Sciences at Monash Health, Monash University and Monash Health, Clayton, Victoria, Australia.
Plos One
|October 7, 2020
Summary
In hypertrophic cardiomyopathy (HCM), reduced left ventricular (LV) longitudinal contraction limits early diastolic motion. This, along with prolonged early diastolic motion, lowers early diastolic mitral annular velocity (e`).
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Echocardiography
Background:
- Early diastolic mitral annular velocity (e`) is a key indicator of left ventricular (LV) diastolic dysfunction in hypertrophic cardiomyopathy (HCM).
- Other aspects of LV long-axis function in HCM, including systolic excursion (SExc) and early diastolic excursion (EDExc), are less understood.
- The impact of HCM on atrial contraction excursion (AExc) and early diastolic motion duration (EDDur) remains unclear.
Purpose of the Study:
- To investigate the effects of HCM on various parameters of LV long-axis function during diastole.
- To explore the relationships between systolic and diastolic mitral annular excursion and early diastolic velocity.
- To identify independent predictors of early diastolic mitral annular excursion and velocity in HCM.
Main Methods:
- Compared 22 subjects with HCM to 22 age- and sex-matched controls.
- Measured SExc, EDExc, e`, AExc, and EDDur using pulsed wave tissue Doppler imaging of septal and lateral walls.
- Utilized multivariate regression analyses to identify predictors of EDExc and e`.
Main Results:
- HCM group showed lower SExc, EDExc, and e`, and longer EDDur compared to controls (p<0.05).
- Septal AExc was lower in HCM, but lateral AExc was not significantly different.
- SExc strongly predicted EDExc (57-86% variance), and EDExc (with EDDur) strongly predicted e` (58-92% variance).
Conclusions:
- Reduced LV longitudinal contraction is the primary cause of decreased EDExc in HCM.
- Lower e` in HCM results from reduced EDExc and prolonged early diastolic motion.
- Atrial contraction does not compensate for the impaired longitudinal function in HCM.
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