Abnormal left ventricular contraction sequence in hypertrophic cardiomyopathy patients: first description of hypersynchrony and invert synchrony.
The aim of this study was to compare left ventricular contraction sequence in patients with hypertrophic cardiomyopathy (HCM) and healthy controls. Normal left ventricular contraction sequence in healthy controls exhibits an apex-to-base delay (ABD) contributing to efficient cardiac mechanics (physiologic asynchrony). Echocardiographic data from 20 controls and 40 HCM patients were prospectively analyzed. Endocardial longitudinal and circumferential strains and ABD were measured using custom-built software. HCM patients had increased circumferential (-36.4 ± 6.0 vs. -32.9 ± 5.0, p < 0.01) and decreased longitudinal (-19.3 ± 6.4 vs. -23.4 ± 5.7, p < 0.01) strains. In controls, physiologic ABD was observed (35.7 ± 18.1 ms). This delay was reduced in HCM patients (5.5 ± 22.7 ms, p < 0.01 vs. controls). There was no interaction between ABD and common clinical or echocardiographic parameters in the HCM population. Left ventricular contraction sequence can be modified in HCM patients, with the loss of the physiologic ABD. This phenomenon is independent from commonly measured parameters.
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Josselin
J
Duchateau
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Claire
C
Cornolle
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Jérome
J
Peyrou
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Philippe
P
Ritter
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Xavier
X
Pillois
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Patricia
P
Réant
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Amélie
A
Reynaud
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France.
Mathieu
M
Landelle
Unité des cardiopathies valvulaires et laboratoire d'échocardiographie, Hôpital Cardiologique du Haut Lévèque, Pessac, France. Electronic address: stephane.lafitte@chu-bordeaux.fr.
Stéphane
S
Lafitte
D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014463:Ultrasonography; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000000981:diagnostic imaging*
Cardiomyopathy; Echocardiography; Hypertrophy; Mechanics; Myocardial contraction