TY - JOUR
T1 - Systolic Myocardial Mechanics in Hypertrophic Cardiomyopathy
T2 - Novel Concepts and Implications for Clinical Status
AU - Carasso, Shemy
AU - Yang, Hua
AU - Woo, Anna
AU - Vannan, Mani A.
AU - Jamorski, Michal
AU - Wigle, E. Douglas
AU - Rakowski, Harry
PY - 2008/6
Y1 - 2008/6
N2 - In hypertrophic cardiomyopathy (HCM), malfunctioning sarcomeric protein, myocyte hypertrophy, fiber disarray, and interstitial fibrosis interfere with systolic myocardial mechanics despite clinically hyperdynamic systolic function. We evaluated local left ventricular (LV) mechanics in 72 patients with HCM and 32 control subjects using 2-dimensional velocity vector imaging. Patients had higher circumferential strain (-34 ± 9 vs -29 ± 8, P < .05) and lower longitudinal strain (-16 ± 4 vs -21 ± 4, P < .05) compared with control subjects. Biplanar strain vector magnitude was similar (-38% ± 8 vs -36 ± 7) in both groups, but was circumferentially oriented in HCM (27 ± 10 vs 39 ± 9 degrees, P < .05). Mid LV rotation was clockwise (opposite to normal). LV outflow tract obstruction and clinical status were related to more circumferentially directed strain and reduced apical biplanar strain. Patients with HCM have more circumferential myocardial strain and apically displaced systolic twist. Functional status and LV outflow tract obstruction were related to decreased strain vector angle and apical mechanics. These findings provide insights into the pathophysiology of HCM.
AB - In hypertrophic cardiomyopathy (HCM), malfunctioning sarcomeric protein, myocyte hypertrophy, fiber disarray, and interstitial fibrosis interfere with systolic myocardial mechanics despite clinically hyperdynamic systolic function. We evaluated local left ventricular (LV) mechanics in 72 patients with HCM and 32 control subjects using 2-dimensional velocity vector imaging. Patients had higher circumferential strain (-34 ± 9 vs -29 ± 8, P < .05) and lower longitudinal strain (-16 ± 4 vs -21 ± 4, P < .05) compared with control subjects. Biplanar strain vector magnitude was similar (-38% ± 8 vs -36 ± 7) in both groups, but was circumferentially oriented in HCM (27 ± 10 vs 39 ± 9 degrees, P < .05). Mid LV rotation was clockwise (opposite to normal). LV outflow tract obstruction and clinical status were related to more circumferentially directed strain and reduced apical biplanar strain. Patients with HCM have more circumferential myocardial strain and apically displaced systolic twist. Functional status and LV outflow tract obstruction were related to decreased strain vector angle and apical mechanics. These findings provide insights into the pathophysiology of HCM.
KW - Echocardiography
KW - Hypertrophic cardiomyopathy
KW - Mechanics
KW - Strain
KW - Tissue tracking
UR - http://www.scopus.com/inward/record.url?scp=43549123433&partnerID=8YFLogxK
U2 - 10.1016/j.echo.2007.10.021
DO - 10.1016/j.echo.2007.10.021
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 18187306
AN - SCOPUS:43549123433
SN - 0894-7317
VL - 21
SP - 675
EP - 683
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 6
ER -