Abstract 15528: Myocardial Deformation Imaging and Obstruction in Hypertrophic Cardiomyopathy, Insights from Cross-sectional and Post-myectomy Analysis
Background: Hypertrophic cardiomyopathy (HCM) has been reported to alter left ventricular deformation. However, little is known about the differences of left ventricular (LV) strain values among healthy and varying levels of HCM patients including non-obstructive and obstructive, nor about the impact of septal reduction therapy on strain values.
Methods: Age- and sex matched patients with HCM and varying degree of obstruction as well as 48 healthy controls were studied. Among HCM patients, 28 subjects had non-obstructive HCM, 27 had mildly symptomatic obstructive HCM, and 34 had HCM requiring septal reduction therapy (either myectomy or alcohol ablation). LV global longitudinal strain (LV-GLS) and circumferential strain as well as routine echocardiography were evaluated. Detailed LV longitudinal strain was assessed with septal and lateral longitudinal strain (Sept.-LS and Lat.-LS). In HCM patients treated with septal reduction, echocardiography was performed before, 3-months, and 1-year after the procedure.
Results: LV-GLS, Sept.-LS, and Lat.-LS of all HCM patients were significantly lower than controls (p<0.001, p<0.001, p<0.05, respectively), and circumferential endocardial and mid strain were higher (p<0.05). Significant differences among controls and varying levels of HCM subgroups were detected only in Sept.-LS, which enabled to stratify the HCM severity (left panel in Figure). In addition, Sept.-LS has the strongest correlation with the average LV wall thickness (right panel in Figure). Furthermore, Sept.-LS was significantly improved after septal reduction, whereas Lat.-LS and circumferential strain did not change.
Conclusions: The strongest relationship between myocardial deformation and obstruction in HCM was found for Sept.-LS. Also, septal reduction procedure preferentially improves Sept.-LS.
Author Disclosures: Y. Kobayashi: None. G. Finocchiaro: None. G. Giraldeau: None. D. Boulate: None. Y. Kobayashi: None. R. Ha: None. D. Lee: None. D. Liang: None. I. Schittger: None. F. Haddad: None. E. Ashley: None.
- © 2014 by American Heart Association, Inc.