title: Effect of septal ablation on regional diastolic dysfunction and diastolic asynchrony in patients with hypertrophic obstructive cardiomyopathy: a follow-up study using speckle tracking echocardiography.
abstract: BACKGROUND
  Percutaneous transluminal septal myocardial ablation (PTSMA) is an alternative therapy for patients with hypertrophic obstructive cardiomyopathy (HOCM) that results in sustained improvement in the global diastolic dysfunction. Regional diastolic abnormalities and diastolic asynchrony are very common and closely related to global diastolic dysfunction. The aim of this study was to examine the effect of PTSMA on regional diastolic dysfunction and diastolic asynchrony in HOCM patients using speckle tracking echocardiography.
  
  
  METHODS
  Strain rate curves were obtained for 18 different segments of the left ventricular (LV) myocardium in 30 HOCM patients 24 hours before and 1 year after PTSMA. The peak strain rate during the isovolumic relaxation period (SRIVR ), the peak early diastolic strain rate (SRE ), and the time from the onset of the QRS-wave to SRE (TSRE ) were measured for each segment. The left atrial volume indexed to the body surface area (LAVI) was measured as a global diastolic index.
  
  
  RESULTS
  At 1 year after PTSMA, there was significant improvement of the global SRIVR (0.14 ± 0.06-0.22 ± 0.07%/sec, P < 0.001) and SRE (0.67 ± 0.24-0.82 ± 0.23%/sec, P = 0.001). The coefficient of variation in TSRE (CVTSRE ) decreased significantly. The changes in the regional myocardial diastolic deformation and CVTSRE correlated well with the reduction in the LAVI.
  
  
  CONCLUSIONS
  Percutaneous transluminal septal myocardial ablation has a favorable effect on regional diastolic abnormalities and diastolic asynchrony, which may partly account for the persistent improvement in global LV diastolic function in HOCM patients after PTSMA.
authors.affiliation: Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical, Beijing, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.forename: Fujian
authors.initials: F
authors.lastname: Duan
authors.forename: Jiansong
authors.initials: J
authors.lastname: Yuan
authors.forename: Shubin
authors.initials: S
authors.lastname: Qiao
authors.forename: Xiuzhang
authors.initials: X
authors.lastname: Lv
authors.forename: Fenghuan
authors.initials: F
authors.lastname: Hu
authors.forename: Weixian
authors.initials: W
authors.lastname: Yang
authors.forename: Jiafen
authors.initials: J
authors.lastname: Zhang
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D003971:Diastole; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000503:physiopathology