title: Impact of septal curvature on regional strain in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  The interventricular septum in hypertrophic cardiomyopathy (HC) has a unique shape, which is characterized by the convex curvature toward the left ventricle (LV). The aim of this study was to examine the relationship between curvature of the LV wall and regional myocardial strain.
  
  
  RESULTS
  Fifty-six patients with HC (mean age, 55±12 years) and 20 age- and sex-matched control subjects (mean age, 56±8 years) were enrolled. The curvature index (1/radius) was measured by drawing along the endocardial surface from the apical 4-chamber and short axis views. Peak systolic strain was calculated in the septal and lateral walls using 2-D speckle tracking echocardiography. The septal curvature index and septal longitudinal strain were significantly lower in the HC group than in the control group. A multivariate model using the HC patient data showed that the septal curvature index and septal thickness were the independent determinants of septal longitudinal strain (septal curvature index: β=-0.421, P<0.001; septal thickness: β=0.401, P=0.002). In addition, global longitudinal strain and E/e' were worse in the lower septal curvature index group compared with the higher group.
  
  
  CONCLUSIONS
  Septal longitudinal strain is associated with the degree of septal curvature. This indicates a possible link between LV wall configuration and regional myocardial function.
authors.affiliation: Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Inoue
authors.forename: Hideki
authors.initials: H
authors.lastname: Okayama
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Nishimura
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nagai
authors.forename: Jun
authors.initials: J
authors.lastname: Suzuki
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Ogimoto
authors.forename: Makoto
authors.initials: M
authors.lastname: Saito
authors.forename: Toyofumi
authors.initials: T
authors.lastname: Yoshii
authors.forename: Go
authors.initials: G
authors.lastname: Hiasa
authors.forename: Takumi
authors.initials: T
authors.lastname: Sumimoto
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Funada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
authors.forename: Jitsuo
authors.initials: J
authors.lastname: Higaki
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006346:Heart Septum / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008955:Models, Cardiovascular; D014463:Ultrasonography; D016277:Ventricular Function, Left