Abstract 17146: Regional Peak Longitudinal Strain on Transthoracic Echocardiogram Distinguished Left Ventricular Myocardium With and Without Fibrosis on 320 Slice CT in Hypertrophic Cardiomyopathy Subjects
Purpose: To distinguish left ventricular myocardium (LVM) with and without focal fibrotic lesions in hypertrophic cardiomyopathy (HCM) subjects, we compared myocardial regional peak longitudinal strain (PLS) values in the LVM with and without 320 slice CT-detected fibrotic lesions and controls using two dimensional (2D) speckle tracking transthoracic echocardiography (TTE).
Methods: A total of 63 subjects (43 consecutive HCM subjects (26 males; mean age, 61.3 yrs) and 20 consecutive normal control subjects (17 males; 61.4 yrs)) undergoing both 320-slice CT (Aquilion one) and TTE (iE-33) within 12 months were retrospectively analyzed. Fibrotic lesions on CT were identified by contrast defects in the early phase and abnormal enhancement in the late phase. No subjects had any significant coronary stenosis on CT. Characteristics of the LVM in the normal control group were considered to be normal on both CT and TTE. On TTE, PLS in each segment of the LVM among 17 lesions were calculated. Strain was examined among three kinds of lesions in the LVM (with and without fibrotic lesions in HCM subjects, and normal control lesions).
Results: In 43 HCM subjects, 90.0% of lesions yielded good tracking on TTE. 57 lesions in 21 subjects showed fibrotic changes. PLS were significantly higher in HCM with fibrotic lesions than in HCM without fibrotic lesions and controls (-7.5±4.4%, -10.8±5.5%, -14.5±6.3%, respectively), (both P<0.001); furthermore these were significantly higher in HCM without fibrotic lesions than in controls (P<0.001). Receiver operating characteristic curves of PLS on TTE revealed an area under curve (AUC) of 0.773 a best cutoff point of -8.7% (sensitivity 70.2%, specificity 74.9%) to differentiate LVM with fibrosis from LVM without fibrosis on CT in HCM subjects.
Conclusions: Regional PLS on 2D speckle tracking TTE (-8.7% in this study) provides useful information noninvasively to distinguish LVM with and without fibrotic lesions on 320 slice CT in HCM subjects.
- © 2012 by American Heart Association, Inc.