Comparison of Resting and Exercise Echocardiographic Parameters as Indicators of Outcomes in Hypertrophic Cardiomyopathy

Echocardiography in Hypertrophic Cardiomyopathy: In with Strain, Out with Straining?

“…The work by Reant et al 13 highlights two unique features about HCM: its hemodynamics and its underlying etiology as a disease of the sarcomere. Whereas the former has been the subject of elegant hemodynamic investigations that started in the cardiac catheterization laboratory and has now continued in the echocardiography laboratory, 2 the latter has been facilitated by advances in STE that have permitted the quantification of global and regional myocardial function.…”

“…Measures of global circumferential and radial strain have been less consistent and have lower reproducibility. 17 The feasibility of STE to investigate patients with HCM was first reported by the same center as the present study by Reant et al 13 : the authors evaluated 26 patients with nonobstructive HCM and normal LV systolic function. 19 Compared with healthy subjects, average longitudinal, transverse, circumferential, and radial strain were reduced in patients with HCM.…”

“…In the present issue of JASE, Reant et al 13 report on their analysis of a multitude of resting and exercise echocardiographic parameters to better predict HCM-related outcomes. This group of experienced investigators prospectively evaluated 115 patients with HCM.…”

“…9 More recent echocardiographic studies with smaller HCM cohorts and shorter observation periods have explored additional Doppler echocardiographic measures, LA volume indexed to body surface area, 10 and Doppler tissue imaging, 11,12 to further refine the risk assessment of patients. The detection of an LA volume index > 27 mL/m 2 , 10 a Doppler tissue imaging lateral annular systolic velocity < 4 cm/sec, 11 and a septal E/e 0 ratio > 15 12 impart an increased risk for HCM-related events.In the present issue of JASE, Reant et al 13 report on their analysis of a multitude of resting and exercise echocardiographic parameters to better predict HCM-related outcomes. This group of experienced investigators prospectively evaluated 115 patients with HCM.…”

Novel Imaging Approaches for Predicting Arrhythmic Risk

“…One study found that HCM patients with impaired LV global longitudinal strain (GLS) <15% at rest to be at higher risk for SCD, sustained VT, resuscitated arrest, and progressive heart failure (HF) symptoms. 16 In addition, the study found LVOT obstruction (≥50 mm Hg) during exercise echocardiography to independently predict poor outcome.…”