Key result
HCM is linked to ~22% worse RV global longitudinal strain and impaired myocardial perfusion.
Why the study?
Changes in right ventricular myocardial perfusion and function in hypertrophic cardiomyopathy patients and their relationship are not well characterized.
Does right ventricular myocardial perfusion and strain differ between patients with hypertrophic cardiomyopathy and healthy subjects?
Cross-Sectional (n=50)
No
Does right ventricular myocardial perfusion and strain differ between patients with hypertrophic cardiomyopathy and healthy subjects?
Absolute Event Rate: -16.66% vs -21.25%
p-value: p=<0.001
In patients with hypertrophic cardiomyopathy, right ventricular myocardial perfusion and strain are reduced and positively correlated, suggesting microvascular impairment contributes to reduced strain.
RV perfusion-strain reductions in HCM are hypothesis-generating; leaves open microvascular mechanisms and outcome impact.
BACKGROUND: To evaluate the changes of right ventricular (RV) myocardial perfusion and function in patients with hypertrophic cardiomyopathy (HCM) by myocardial contrast echocardiography (MCE) and speckle tracking (2D-STE), and to explore the relationship between RV myocardial perfusion and strain. METHODS: Conventional ultrasound, MCE and 2D-STE were performed on 29 HCM patients and 21 healthy subjects to analyze RV myocardial perfusion, RV global strain, RV free wall strain, and strain of each segment. The correlation between RV myocardial perfusion and strain was further analyzed in HCM patients. RESULTS: MCE results showed that the regional myocardial perfusion of the RV in HCM patients was decreased. Compared with the normal control group, the mean slope (β) in the middle and apical segments of the RV free wall, and the peak intensity (A), β, myocardial blood flow (MBF) of the ventricular septum decreased in HCM patients (P < 0.05). RV function was impaired in HCM patients. The RV global strain (RV GLS), and the strain of RV free wall and each segment were lower than those in the normal control group (P < 0.05). Correlation analysis showed that there was a certain correlation between RV myocardial perfusion and strain, such as the β of the whole RV in HCM group had a positive correlation with the strain of the middle segment of the interventricular septum (r = 0.550, P = 0.002). CONCLUSIONS: The regional myocardial perfusion and strain of the RV in HCM patients are reduced, and there is a positive correlation between them, suggesting that the reduction of myocardial strain may be related to the impairment of myocardial microcirculation.
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Cao et al. (2024) conducted a cross-sectional in Hypertrophic cardiomyopathy (n=50). Hypertrophic cardiomyopathy vs. Healthy subjects was evaluated on Right ventricular global longitudinal strain (RV GLS) (p=<0.001). Patients with hypertrophic cardiomyopathy had significantly impaired right ventricular global longitudinal strain (-16.66% vs -21.25%, p<0.001) and reduced regional myocardial perfusion compared to healthy controls.
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