Key result
Hypertrophic cardiomyopathy was associated with significantly lower diastolic wall shear stress (0.004 N/m2) compared to healthy controls (0.175 N/m2, P=0.027) and dilated cardiomyopathy (0.397 N/m2, P<0.001).
Why the study?
Vector flow mapping allows investigation of intracardiac blood flow mechanics, but whether alterations in energy loss and wall shear stress differ among HCM, DCM, and normal controls remained to be evaluated.
Does color Doppler vector flow mapping identify differences in left ventricular wall shear stress and energy loss in children and adolescents with hypertrophic or dilated cardiomyopathy compared to healthy controls?
Observational (n=85)
No
Does color Doppler vector flow mapping identify differences in left ventricular wall shear stress and energy loss in children and adolescents with hypertrophic or dilated cardiomyopathy compared to healthy controls?
Vector flow mapping reveals that children and adolescents with hypertrophic cardiomyopathy have significantly elevated indexed systolic energy loss and altered diastolic wall shear stress compared to those with dilated cardiomyopathy and healthy controls.
Answers are grounded in this paper and cite their sources.
Diastolic WSS differences may distinguish HCM from DCM; leaves open whether vector flow mapping improves phenotyping or outcomes.
Vector flow mapping is an emerging echocardiographic method allowing for investigation of intracardiac blood flow mechanics, wall shear stress (WSS), and energy loss (EL). We hypothesized that alterations in EL and WSS will differ among subjects with hypertrophic (HCM), dilated (DCM) cardiomyopathy, and normal controls. Echocardiograms were prospectively performed with the ProSound F75CV (Hitachi HealthCare., Tokyo, Japan) on all subjects. 2D color Doppler cine loop images were obtained from apical 5 and the apical long axis views and stored digitally. Measurements were averaged over three cardiac cycles using VFM software to derive flow patterns, WSS, and EL. Standard left ventricular (LV) systolic and diastolic functional parameters were also obtained. A total of 85 subjects, 22 with HCM (age 18 ± 9 yrs.), 18 DCM (age 18 ± 9 yrs.), and 45 age and gender matched controls were included in the study. Diastolic wall shear stress was found significantly different in HCM (0.004 ± 0.185 N/m2) compared with DCM (0.397 ± 0.301 N/m2, P < 0.001), and controls (0.175 ± 0.255 N/m2, P = 0.027). Furthermore, indexed systolic EL was found to be significantly elevated in HCM (13.91 ± 13.17 mW/m2/m3) compared with DCM (8.17 ± 9.77 mW/m2/m3, P < 0.001), but not controls (6.45 ± 7.47 mW/m2/m3). Differences in abnormal ventricular mechanics observed in HCM and DCM are reflected in both EL and WSS, and are suggestive that changes in energetic parameters may represent novel indices of ventricular dysfunction.
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Craft et al. (2020) conducted an observational in Cardiomyopathy (Hypertrophic and Dilated) (n=85). Hypertrophic cardiomyopathy vs. Healthy controls was evaluated on Diastolic wall shear stress (N/m2) (p=0.027). Hypertrophic cardiomyopathy was associated with significantly lower diastolic wall shear stress (0.004 N/m2) compared to healthy controls (0.175 N/m2, P=0.027) and dilated cardiomyopathy (0.397 N/m2, P<0.001).
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