Two-dimensional strain profiles in patients with physiological and pathological hypertrophy and preserved left ventricular systolic function: a comparative analyses.
OBJECTIVE
This study was designed to examine the utility of two-dimensional strain (2DS) or speckle tracking imaging to typify functional adaptations of the left ventricle in variant forms of left ventricular hypertrophy (LVH).


METHODS
Cross-sectional study.


METHODS
Urban tertiary care academic medical centres.


METHODS
A total of 129 subjects, 56 with hypertrophic cardiomyopathy (HCM), 34 with hypertensive left ventricular hypertrophy (H-LVH), 27 professional athletes with LVH (AT-LVH) and 12 healthy controls in sinus rhythm with preserved left ventricular systolic function.


METHODS
Conventional echocardiographic and tissue Doppler examinations were performed in all study subjects. Bi-dimensional acquisitions were analysed to map longitudinal systolic strain (automated function imaging, AFI, GE Healthcare, Waukesha, Wisconsin, USA) from apical views.


RESULTS
Subjects with HCM had significantly lower regional and average global peak longitudinal systolic strain (GLS-avg) compared with controls and other forms of LVH. Strain dispersion index, a measure of regional contractile heterogeneity, was higher in HCM compared with the rest of the groups. On receiver operator characteristics analysis, GLS-avg had excellent discriminatory ability to distinguish HCM from H-LVH area under curve (AUC) (0.893, p<0.001) or AT-LVH AUC (0.920, p<0.001). Tissue Doppler and LV morphological parameters were better suited to differentiate the athlete heart from HCM.


CONCLUSIONS
2DS (AFI) allows rapid characterisation of regional and global systolic function and may have the potential to differentiate HCM from variant forms of LVH.
Division of Cardiology, Wayne State University, Detroit, Michigan, USA.
Luis
L
Afonso
Ashok
A
Kondur
Mengistu
M
Simegn
Ashutosh
A
Niraj
Pawan
P
Hari
Ramanjit
R
Kaur
Preeti
P
Ramappa
Jyotiranjan
J
Pradhan
Deepti
D
Bhandare
Kim A
KA
Williams
Sandip
S
Zalawadiya
Aurelio
A
Pinheiro
Theodore P
TP
Abraham