What does this research mean for the field?

Patients with hypertrophic cardiomyopathy exhibit impaired short-axis systolic function, evidenced by significantly lower peak systolic radial and circumferential strain compared to healthy subjects. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 29, 2018Open Access

Left ventricular short-axis systolic function changes in patients with hypertrophic cardiomyopathy detected by two-dimensional speckle tracking imaging

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Hypertrophic cardiomyopathy (n=78). Intervention: 2-dimensional speckle tracking imaging (2D-STI) vs. Healthy subjects. Primary outcome: Peak systolic radial strain of the septum (p=<0.001).

JHJun HuangGuangdong Medical College ZYZi-Ning YanSecond Affiliated Hospital of Jilin University YRYi-Fei RuiChangzhou No.2 People's Hospital

Key Result

Patients with hypertrophic cardiomyopathy had significantly lower peak systolic radial strain of the septum compared to healthy subjects (27.88% vs 42.39%, p<0.001), indicating impaired short-axis systolic function.

Study Design

Type

Observational (n=78)

Multicenter

Structured PICO

Does 2D speckle tracking imaging detect impaired short-axis systolic function in patients with hypertrophic cardiomyopathy compared to healthy subjects?

Population

78 subjects (37 patients with hypertrophic cardiomyopathy [wall thickness ≥ 15 mm, non-dilated LV] and 41 age- and gender-matched healthy subjects).

Intervention

2-dimensional speckle tracking imaging (2D-STI) to assess short-axis systolic function

Comparator

Healthy subjects with normal conventional echocardiography

Outcome

Peak systolic circumferential strain of endocardial, middle, and epicardial layers, peak systolic radial strain, and peak systolic rotational degrees at different short-axis levelssurrogate

2D speckle tracking imaging reveals that short-axis systolic function, including circumferential and radial strain, is impaired in HCM patients despite preserved left ventricular ejection fraction.

Main Result

Absolute Event Rate: 27.88% vs 42.39%

p-value: p=<0.001

Limitations

The relationship of decreasing short axis functions to a clinical outcome or event is not investigated.
Small number of patients.
Did not evaluate the relationship with other image techniques, such as cardiac MR, SPECT.

Abstract

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a genetic disease was characterised by left ventricular hypertrophy (LVH), myocardial fibrosis, fiber disarray. The short-axis systolic function is important in left ventricle function. METHODS: Forty one healthy subjects and 37 HCM patients were enrolled for this research. Parasternal short-axis at the basal, middle, and apical levels were acquired by Echocardiography. The peak systolic circumferential strain of the endocardial, the middle and the epicardial layers, the peak systolic radial strain, and the peak systolic rotational degrees at different short-axis levels were measured by 2-dimensional speckle tracking imaging (2D-STI). RESULTS: The peak systolic circumferential strain of the septum and anterior walls in HCM patients was significantly lower than normal subjects. All of the peak systolic radial strain in HCM patients was significantly lower than normal subjects. The rotational degrees at the base and middle short-axis levels in HCM patients were larger than normal subjects. The interventricular septal thickness in end-diastolic period correlated to the peak systolic circumferential strain of the septum wall. CONCLUSIONS: The short-axis systolic function was impaired in HCM patients. The peak circumferential systolic strain of the different layers, peak systolic radial strain and rotation degrees of the different short-axis levels detected by 2D-STI are very feasible for assessing the short-axis function in HCM patients.

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