Evaluation of Left Ventricular Diastolic Function by Global Strain Rate Imaging in Patients with Obstructive Hypertrophic Cardiomyopathy: A Simultaneous Speckle Tracking Echocardiography and Cardiac Catheterization Study. Issue 5 (13th November 2013)

• Record Type: Journal Article
• Authors: Chen, Shi; Yuan, Jiansong; Qiao, Shubin; Duan, Fujian; Zhang, Jiafen; Wang, Hao
• Is Part Of: Echocardiography. Volume 31:Issue 5(2014)
• Page Start: 615
• Page End: 622
• Publication Date: 2013-11-13
• Subjects: Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.12424
• Languages: English
• ISSNs: 0742-2822

Abstract

<abstract abstract-type="main" id="echo12424_pre-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="echo12424-sec-0001" sec-type="section"> <title>Background</title> <p>Impaired left ventricular (LV) diastolic function is a common pathophysiological feature of patients with hypertrophic cardiomyopathy (HCM). The noninvasive evaluation of diastolic function in these patients remains a challenge. Speckle tracking echocardiography (STE) provides direct information on intrinsic myocardial function and may improve the diagnostic of diastolic dysfunction in HCM patients.</p> </sec> <sec id="echo12424-sec-0002" sec-type="section"> <title>Methods and Results</title> <p>We retrospectively analyzed 51 patients with obstructive HCM (HOCM). Strain rate (SR) curves were obtained for 18 different segments of the LV myocardium. The peak SR during the isovolumic relaxation period (SR<sub>IVR</sub>) and the peak early diastolic strain rate (SR<sub>E</sub>) were measured for each segment. Cardiac catheterization was performed within 24 hours after echocardiographic analysis. LV end‐diastolic pressure (LVEDP) was measured and time constant of myocardial relaxation (τ) was calculated. We therefore correlated STE‐derived with invasive indices and compared it with flow and tissue Doppler measurements. SR<sub>IVR</sub> and SR<sub>E</sub> were significantly reduced in all 51 HOCM patients (0.16 ± 0.09%/sec and 0.71 ± 0.25%/sec).The ratio of peak early mitral inflow velocities to SR<sub>IVR</sub> and SR<sub>E</sub> (E/SR<sub>IVR</sub> and E/SR<sub>E</sub>) correlated well with LVEDP (r = 0.760, P < 0.001; r = 0.401, P = 0.004). Receiver operating characteristic analysis shown E/SR<sub>E</sub> ratio had the largest under curve area in predicting HOCM patients with seriously elevated LVEDP. In addition, SR<sub>IVR</sub> and SR<sub>E</sub> significantly related with τ (r = −0.611, P < 0.001; r = −0.369, P = 0.008).</p> </sec> <sec id="echo12424-sec-0003" sec-type="section"> <title>Conclusions</title> <p>Diastolic function was seriously impaired in HOCM patients. The E/SR<sub>E</sub> ratio can be used to predict LVEDP with acceptable accurate in HOCM patients. In addition, SR<sub>IVR</sub> is a reliable parameter to assess LV relaxation in patients with HOCM.</p> </sec> </abstract>