Regional abnormalities of myocardial deformation in patients with hypertrophic cardiomyopathy: correlations with delayed enhancement in cardiac magnetic resonance.
OBJECTIVE
Hypertrophic cardiomyopathy (HCM) is a genetic disease histologically characterized by a profound disarray of myocardial fibres and by local fibrosis. We sought to characterize regional left ventricular contractility in HCM patients using deformation analysis and to compare it with the presence or absence of delayed enhancement in cardiac magnetic resonance (CMR).


RESULTS
We studied 58 HCM patients (mean age 41 years, 37 male). The control population comprised 15 normal subjects. Colour tissue-Doppler imaging was acquired in two-dimensional mode from apical four-chamber and two-chamber views; off-line analysis was performed in four basal and four middle left ventricular segments. Gadolinium-enhanced CMR was performed in 36 HCM patients. In HCM patients, peak systolic strain was not uniform across left ventricular segments; differences were not related to site or thickness of the segment analysed. Paradoxically, positive systolic strain values were measured in six middle segments. Delayed CMR enhancement was associated with lower peak systolic strain (P = 0.007). Regional non-uniformities in peak systolic strain were not observed in normal subjects.


CONCLUSIONS
Areas of reduced left ventricular contractility in deformation analysis are associated with delayed CMR enhancement in patients with HCM.
Division of Cardiology, Fondazione IRCCS Policlinico S. Matteo, Pavia 27100, Italy. s.ghio@smatteo.pv.it
Stefano
S
Ghio
Miriam
M
Revera
Francesca
F
Mori
Catherine
C
Klersy
Arturo
A
Raisaro
Claudia
C
Raineri
Alessandra
A
Serio
Michele
M
Pasotti
Luigi Oltrona
LO
Visconti
D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis*; D016022:Case-Control Studies; D016001:Confidence Intervals; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
D005682:Gadolinium