Myocardial Work in Apical Hypertrophic Cardiomyopathy

Area of Science:

• Cardiology
• Echocardiography
• Cardiovascular Imaging

Background:

• Pressure-strain loop analysis is an emerging echocardiographic method for assessing myocardial work.
• Its application in apical hypertrophic cardiomyopathy (ApHCM) remains unexplored.
• This study investigates myocardial work indices in ApHCM versus non-ApHCM patients.

Purpose of the Study:

• To compare myocardial work indices between ApHCM and non-ApHCM patients.
• To explore associations between myocardial work indices and clinical variables.
• To examine the relationship between myocardial work indices and late gadolinium enhancement (LGE) on cardiac MRI.

Main Methods:

• Retrospective analysis of 48 ApHCM and 69 non-ApHCM patients.
• Measurements included global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), and global work efficiency.
• Cardiac MRI data were analyzed for 34 ApHCM and 51 non-ApHCM patients.

Main Results:

• ApHCM patients showed significantly impaired GLS, GWI, and GCW compared to non-ApHCM patients.
• Reduced GWI and GCW in ApHCM correlated with elevated N-terminal pro-b-type natriuretic peptide, abnormal troponin, and increased left ventricular wall thickness.
• Global constructive work had modest accuracy for predicting LGE in ApHCM, while GLS was a strong predictor in non-ApHCM.

Conclusions:

• Myocardial work indices are significantly impaired in ApHCM patients.
• These indices correlate with key clinical variables in ApHCM.
• Global longitudinal strain, GWI, and GCW are less predictive of cardiac fibrosis in ApHCM than in non-ApHCM.