Key result
Impaired 3D GLS correlates with lower peak VO2 and worse functional capacity.
Why the study?
Early identification of systolic dysfunction may identify hypertrophic cardiomyopathy patients at risk for adverse outcomes, but the correlation between 3D speckle-tracking echocardiography myocardial deformation parameters and functional capacity needed evaluation.
Do myocardial deformation parameters obtained by 3D speckle-tracking echocardiography correlate with functional capacity in adult patients with hypertrophic cardiomyopathy?
Cross-Sectional (n=74)
Yes
Do myocardial deformation parameters obtained by 3D speckle-tracking echocardiography correlate with functional capacity in adult patients with hypertrophic cardiomyopathy?
Effect estimate: β1 0.10 (95% CI 0.03-0.23)
p-value: p=0.014
Impaired myocardial deformation parameters evaluated by 3DSTE, specifically 3D GLS, are independently associated with worse functional capacity in patients with hypertrophic cardiomyopathy.
3D GLS association with peak VO2 in HCM is hypothesis-generating; larger prospective studies needed before clinical adoption.
Purpose : Patients with hypertrophic cardiomyopathy may exhibit impaired functional capacity, associated with increased morbidity and mortality. Systolic function is one of the determinants of functional capacity. Early identification of systolic disfunction may identify patients at risk for adverse outcomes. Myocardial deformation parameters, derived from three-dimensional (3D) speckle-tracking echocardiography (3DSTE) are are useful tools to assess left ventricular systolic function, and are often abnormal before a decline in ejection fraction is seen. The aim of this study was to evaluate the correlation between myocardial deformation parameters obtained by 3DSTE and functional capacity in patients with hypertrophic cardiomyopathy. Methods : Seventy-four hypertrophic cardiomyopathy adult patients were prospectively evaluated. All patients underwent a dedicated 2D and 3D echocardiographic examination and cardiopulmonary exercise testing (CPET). Results: Values of 3D global radial (GRS), longitudinal (3DGLS) and circumferential strain (GCS) were overall reduced in our population: 99% (n=73) of the patients had reduced GLS, 82% (n=61) had reduced GRS and all patients had reduced GCS obtain by 3DSTE. Average peak VO 2 was 21.01 (6.08) ml/Kg/min; 58% (n=39) of the patients showed reduced exercise tolerance (predicted peak VO 2 < 80%). The average VE/VCO 2 slope was 29.0 (5.3) and 16% (n= 11) of the patients had impaired ventilatory efficiency (VE/VCO 2 >34). In multivariable analysis, 3D GLS (β 1 = 0.10, 95%CI: 0.03;0.23, p=0.014), age (β 1 = -0.15, 95%CI: -0.23; -0.05, p=0.002) and female gender (β 1 =-5.10, 95%CI: -7.7; -2.6, p<0.01) were independently associated with peak VO2. No association was found between left ventricle ejection fraction obtain and peak VO 2 (r=0.161, p=0.5). Conclusion: Impaired myocardial deformation parameters evaluated by 3DSTE were associated with worse functional capacity assessed by peak VO 2 .
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Cardoso et al. (2023) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=74). Three-dimensional speckle-tracking echocardiography (3DSTE) was evaluated on Association between 3D global longitudinal strain (3D GLS) and peak VO2 (β1 0.10, 95% CI 0.03-0.23, p=0.014). Three-dimensional global longitudinal strain (3D GLS) was independently associated with peak VO2 (β1 0.10), indicating that impaired myocardial deformation correlates with worse functional capacity.
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