Key result
HCM links to reduced systolic and early diastolic excursion, lower e`, and longer diastolic duration.
Why the study?
The effects of HCM on early diastolic excursion, atrial contraction excursion, duration of early diastolic motion, and their relationships with systolic excursion and e` were unknown.
How do left ventricular long-axis function parameters differ between patients with hypertrophic cardiomyopathy and matched controls?
Case-Control (n=44)
How do left ventricular long-axis function parameters differ between patients with hypertrophic cardiomyopathy and matched controls?
p-value: p=<0.05
In hypertrophic cardiomyopathy, the decrease in left ventricular longitudinal contraction is the major mechanism accounting for lower early diastolic excursion, which along with prolonged early diastolic motion explains the lower e` velocity.
BACKGROUND: The peak velocity of early diastolic mitral annular motion (e`) is believed to provide sensitive detection of left ventricular (LV) diastolic dysfunction in hypertrophic cardiomyopathy (HCM), but other aspects of LV long-axis function in HCM have received less attention. Systolic mitral annular excursion (SExc) is also reduced in HCM and must be an intrinsic limitation to the extent of the subsequent motion during diastole. However, the effects of HCM on excursion during early diastole (EDExc) and atrial contraction (AExc), the duration of early diastolic motion (EDDur), and the relationships of EDExc with SExc, and of e`with EDExc and EDDur, are all unknown. METHODS: The study group was 22 subjects with HCM and there were 22 age and sex matched control subjects. SExc, EDExc, e`, AExc and EDDur were measured from pulsed wave tissue Doppler signals acquired from the septal and lateral walls. In the combined group of HCM and control subjects, multivariate analyses were performed to identify independent predictors of EDExc and e`for both LV walls. RESULTS: SExc, EDExc and e`were all lower, and EDDur was longer in the HCM group compared to the control group for both LV walls (p<0.05 for all). In contrast, AExc was lower for the septal wall in the HCM group (p<0.05), but not different between the groups for the lateral wall. In regression analyses of the combined group, EDExc was positively correlated with SExc, and SExc explained 57-86% of the variances in septal and lateral EDExc, e`was positively correlated with EDExc, and EDExc explained 58-68% of the variances of e`, whereas the combination of EDExc with EDDur explained 87-92% of the variances in e`. A diagnosis of HCM was not an independent predictor of EDExc when in combination with SExc, but was a minor contributor to the prediction of e`in combination with EDExc and EDDur. CONCLUSION: In HCM, the decrease in LV longitudinal contraction is the major mechanism accounting for a lower EDExc, the lower e`is accounted for by contributions from the lower EDExc and prolongation of early diastolic motion, and there is no atrial compensation for the reduction of long-axis contraction.
No takes yet. Share an insight, caveat, or question.
Peverill et al. (2020) conducted a case-control in Hypertrophic cardiomyopathy (n=44). Hypertrophic cardiomyopathy vs. Age and sex matched control subjects was evaluated on Systolic mitral annular excursion (SExc), early diastolic excursion (EDExc), e`, atrial contraction excursion (AExc), and duration of early diastolic motion (EDDur) (p=<0.05). Hypertrophic cardiomyopathy was associated with lower systolic and early diastolic excursion and e`, and longer early diastolic duration compared to matched controls (p<0.05 for all).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: