Exploring the nexus between myocardial microcirculation perfusion and contractile mechanics in nonobstructive hypertrophic cardiomyopathy

This study quantitatively analyzed myocardial microcirculation perfusion in nonobstructive hypertrophic cardiomyopathy (HCM) patients and evaluated their mechanical properties. A total of 56 individuals were involved, consisting of 28 nonobstructive HCM patients and an equal number of healthy volunteers. Each participant underwent comprehensive diagnostic procedures, including two-dimensional echocardiography, contrast-enhanced myocardial ultrasound (MCE), and two-dimensional speckle tracking imaging. Nonobstructive HCM patients were further classified into two groups based on the extent of myocardial hypertrophy: hypertrophic segmental (HS) myocardium and non-hypertrophic segmental myocardium. The study's findings indicated no significant differences in essential demographic factors such as age, height, and weight between the nonobstructive HCM and control groups. However, significant disparities were observed in myocardial perfusion and mechanical properties between these groups, particularly in aspects such as myocardial thickness, tricuspid regurgitation, and left atrial volume. Notably, the myocardial global longitudinal strain (GLS) is significantly decreased in patients with nonobstructive HCM, whereas the global circumferential strain changes are not easily discernible. A notable positive correlation existed within the HS between myocardial perfusion parameters and mechanical properties. The study concluded that myocardial microcirculation perfusion and GLS are impaired in nonobstructive HCM patients, with more pronounced damage in HS, closely associated with alterations in myocardial mechanical characteristics.