Key result
Patients with hypertrophic obstructive cardiomyopathy had significantly impaired right ventricular function compared to controls, demonstrated by a higher myocardial performance (Tei) index (0.61 vs 0.49).
Why the study?
Do strain, strain rate, and tissue Doppler imaging detect right ventricular impairment in patients with HOCM post-alcohol septal ablation compared to controls?
Case-Control (n=41)
No
Do strain, strain rate, and tissue Doppler imaging detect right ventricular impairment in patients with HOCM post-alcohol septal ablation compared to controls?
Absolute Event Rate: 0.61% vs 0.49%
p-value: p=<0.01
Tissue Doppler imaging appears more sensitive than strain and strain rate for detecting subclinical right ventricular systolic and diastolic impairment in patients with HOCM after alcohol septal ablation.
TDI may outperform strain for detecting subclinical RV impairment in HOCM post-ablation; leaves open clinical adoption pending prospective studies.
We investigated the utility of strain, strain rate, and tissue Doppler imaging (TDI) for the evaluation of the right ventricle (RV) impairment in patients with a hypertrophic obstructive cardiomyopathy (HOCM) who underwent a successful alcohol septal ablation (ASA) and were without RV hypertrophy. A group of 19 patients suffering from HOCM with 22 controls was compared. The parameters of TDI were evaluated in mitral and tricuspid annulus. Strain and strain rate derived from TDI were assessed in an apical free wall of RV, as well as in basal segments of the left ventricle. Between both groups, there were significant differences only in isovolumic pre-ejection time (79.2+/-17.3 ms vs. 58.5+/-8.1 ms, p<0.01), isovolumic relaxation time (104.7+/-26.2 ms vs. 77.3+/-24.5 ms, p<0.01), myocardial performance (Tei) index measured from TDI (0.61+/-0.14 vs. 0.49+/-0.09, p<0.01), and early peak diastolic velocity of TDI (10.6+/-1.67 cm/s vs. 12.6+/-2.21 cm/s; p<0.05). Our results suggest the impairment of both systolic and diastolic RV function in patients suffering from HOCM. TDI-related parameters appear to be more sensitive than strain and strain rate for evaluation.
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Zemánek et al. (2010) conducted a case-control in Hypertrophic obstructive cardiomyopathy (n=41). Hypertrophic obstructive cardiomyopathy (post-ASA) vs. Healthy controls was evaluated on Myocardial performance (Tei) index measured from TDI (p=<0.01). Patients with hypertrophic obstructive cardiomyopathy had significantly impaired right ventricular function compared to controls, demonstrated by a higher myocardial performance (Tei) index (0.61 vs 0.49).
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