Key result
In patients with hypertrophic cardiomyopathy, regional systolic strain and peak systolic strain rate correlated with left ventricular wall thickness (r=0.50 and r=0.63, respectively; P<0.001).
Why the study?
Is heterogeneity of regional systolic function detected by tissue Doppler imaging linked to impaired global left ventricular relaxation in hypertrophic cardiomyopathy?
Observational (n=52)
Yes
Is heterogeneity of regional systolic function detected by tissue Doppler imaging linked to impaired global left ventricular relaxation in hypertrophic cardiomyopathy?
Heterogeneity of regional LV systolic function in HCM is linked to impaired global LV relaxation, suggesting a mechanistic link between regional hypertrophy and global diastolic dysfunction.
Answers are grounded in this paper and cite their sources.
May link regional hypertrophy to diastolic dysfunction in HCM; hypothesis-generating and requires prospective validation before clinical adoption.
OBJECTIVE: To evaluate regional and global left ventricular (LV) function and LV wall thickness (LVWT) in patients with hypertrophic cardiomyopathy (HCM). DESIGN AND SETTING: Observational study at the National Cardiovascular Centre and Nagoya University Hospital in Japan. PARTICIPANTS: Thirty-six patients with HCM and 16 patients with hypertensive LV hypertrophy (LVH). MAIN OUTCOME MEASURES: Conventional echocardiography and strain rate (SR) imaging derived from tissue Doppler imaging were performed. Systolic strain (epsilon(sys)), peak systolic SR (SR(sys)), peak early diastolic SR (SR(dia)) and LVWT were obtained from eight LV segments. LV pressure was simultaneously recorded with a high-fidelity micromanometer. RESULTS: The regional epsilon(sys) and SR(sys) were correlated with LVWT in patients with HCM (r = 0.50, p<0.001 and r = 0.63, p<0.001, respectively) but not in patients with hypertensive LVH. The standard deviations of LVWT, epsilon(sys) and SR(sys) obtained from the eight LV segments of each subject were greater for patients with HCM than for patients with hypertensive LVH. The standard deviation of LVWT was correlated with those of epsilon(sys) and SR(sys) (r = 0.55, p<0.001 and r = 0.56, p<0.001, respectively). The standard deviations of LVWT, epsilon(sys) and SR(sys) were correlated with tau (r = 0.35, p<0.05; r = 0.47, p<0.001; and r = 0.39, p<0.005, respectively). CONCLUSIONS: Heterogeneity of regional LV systolic function detected by SR imaging is in part attributable to heterogeneity of LVH and may be linked to impaired global LV relaxation in HCM.
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Kato et al. (2008) conducted an observational in Hypertrophic cardiomyopathy (n=52). Hypertrophic cardiomyopathy vs. Hypertensive left ventricular hypertrophy was evaluated on Correlation of regional systolic strain and peak systolic strain rate with left ventricular wall thickness (r = 0.50 and r = 0.63, p=<0.001). In patients with hypertrophic cardiomyopathy, regional systolic strain and peak systolic strain rate correlated with left ventricular wall thickness (r=0.50 and r=0.63, respectively; P<0.001).
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