Left ventricular myocardial strain and electrocardiographic changes in children with hypertrophic cardiomyopathy

Abstract

Introduction. Hypertrophic cardiomyopathy is one of the most common diseases of the myocardium in children. Meanwhile, the relationship between indicators of strain and electrocardiographic changes, their diagnostic significance for children with hypertrophic cardiomyopathy remains an insufficiently well-studied issue.Purpose. Тo analyze the relationship between indicators of strain of the left ventricular and ECG in children with hypertrophic cardiomyopathy (HCM).Materials and methods. Have been examined 61 patients with an asymmetric form of hypertrophic cardiomyopathy aged from 7 to 17 years. Of these, 45 (73.8%) children with nonobstructive form, 16 (26.2%) children with obstructive form. Electrocardiography (ECG) and 24-hour Holter monitoring ECG had performed. The parameters of global longitudinal, radial and circular of the left ventricular myocardial strain and their rates had determined by echocardiography in the 2D speckle tracking modeResults. In children with HCM, ECG signs of hypertrophy were studied (deviation of the electrical axis to the left, the predominance of the R wave in lead I, V6 over the S wave, the predominance of the S wave in lead V1 over the R wave) and myocardial ischemia (inversion of the T wave and a decrease in the ST segment in the leads I, II, V5, V6), rhythm and conduction disorders (ventricular extrasystole, degree I atrioventricular block, expansion of the QRS complex in leads V1-V3, incomplete blockade of the anterior left branch of the His bundle, increased duration of terminal activation), which significantly prevailed in obstructive form versus non-obstructive form. A decrease in the global longitudinal, radial, circular strain of the left ventricular myocardium and their rates had found, which had significantly more pronounced in the group with obstructive HCM. Inverse correlations had found between the parameters of strain and ECG-signs of hypertrophy and myocardial ischemia, conduction disorders, more pronounced between the parameters of longitudinal strain and ECG with a significant predominance in the obstructive form of the disease.Conclusions. In children with obstructive HCM, compared with the non-obstructive form, there have significantly more pronounced signs of myocardial hypertrophy and ischemia, rhythm and conduction disorders on the ECG and with 24-hour Holter monitoring ECG.