Evaluation of global and regional myocardial work in hypertrophic cardiomyopathy patients by left ventricular pressure-strain loop

Abstract

Objective This study aimed to investigate the value of left ventricular (LV) press-strain loop (PSL) in evaluating global and regional myocardial work (MW) in hypertrophic cardiomyopathy (HCM) patients. Methods A total of 30 HCM patients with interventricular septum hypertrophy (HCM group) and 35 healthy subjects (control group) were selected from First Hospital of Qinhuangdao. The general clinical data and conventional ultrasound parameters of two groups were acquired. The MW parameters were analyzed using LV PSL. The regional MW parameters in the HCM group were compared between ventricular septum and the free walls of left ventricle. Results The epicardial adipose tissue thickness of the HCM group was significantly greater than that of the control group (P < 0.05). Global work efficiency was significantly reduced, while global wasted work was increased in patients with HCM compared with controls (all P < 0.05). The HCM group was compared in the group, to be specific, in the HCM group, the work index, the work efficiency, and the longitudinal strain on the interventricular septum were lower than those on the free wall (all P < 0.05). Conclusion PSL is more effective than LVEF in assessing left ventricular systolic function in HCM and is able to quantify regional myocardial work in the ventricular septum in HCM patients with preserved LVEF, suggesting a novel idea for clinical diagnosis and assessment.

Interventricular Septal Involvement Is Associated with More Impaired Ventricular Function and Mechanics in Apical Hypertrophic Cardiomyopathy

“…This was not accounted for in the pressure–strain loop assessment and may have meant that myocardial work was underestimated. While some investigators suggest adding the peak or mean dynamic pressure gradient to the brachial cuff pressure used in myocardial work estimation, others have shown good accuracy and predictive value without accounting for the additional afterload, and this remains unsettled in the published literature [ 29 , 30 ]. Fifth, cardiac magnetic resonance imaging was not routinely performed or available for review, which is a modality important in HCM for myocardial tissue characterization and the assessment of late gadolinium enhancement.…”