Impact of Global and Segmental Hypertrophy on Two-Dimensional Strain Derived from Three-Dimensional Echocardiography in Hypertrophic Cardiomyopathy: Comparison with Healthy Subjects.
BACKGROUND
Patients with hypertrophic cardiomyopathy (HCM) present unusual myocardial mechanics. The aim of this study was to assess the impact of hypertrophy on global and regional two-dimensional (2D) strain derived from both tomographic images (2D/2D) and volumetric image acquisition (2D/three-dimensional [3D]) in patients with HCM compared with control subjects.


METHODS
Comprehensive resting 2D and 3D echocardiography was performed in 40 patients with HCM and in 53 control subjects, with comparable distributions of age, gender, and left ventricular (LV) ejection fraction. LV global and segmental measurements of all 2D/2D and 2D/3D peak strain components (global and segmental longitudinal strain, global and segmental circumferential strain, global and segmental radial strain, and global and segmental area strain) and 3D indexed LV end-diastolic myocardial mass were obtained from all patients. LV wall thickness was assessed in short-axis views and classified in four quartiles (<10.5, 10.5-13.0, 13.0-16.5, and >16.5 mm).


RESULTS
The reproducibility of 2D/3D strain was similar or greater and more consistent for all components compared with 2D/2D strain analysis. There was a significant correlation between 3D LV end-diastolic mass and all 2D/3D strain components (P < .05). Two-dimensional/3D global circumferential strain had the strongest association with 3D LV ejection fraction (r = 0.50, P = .001). For segmental deformation, patients with HCM had lower longitudinal deformation whatever the LV wall thickness, whereas circumferential function was increased in nonhypertrophied and poorly hypertrophied segments compared with control subjects.


CONCLUSIONS
Two-dimensional/3D strain is a reliable technique to assess myocardial deformation. Myocardial mass is related to 2D/3D strain components in patients with HCM. Circumferential deformation, compared with longitudinal deformation, seems to be the main component of the maintenance of systolic function in HCM.
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Damien
D
Voilliot
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Olivier
O
Huttin
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Néfissa
N
Hammache
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Laura
L
Filippetti
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France; Centre Hospitalier d' Aix-en-Provence, Service de Cardiologie, France.
Thibaud
T
Vaugrenard
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Etienne
E
Aliot
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Nicolas
N
Sadoul
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France.
Yves
Y
Juillière
Centre Hospitalier Universitaire de Nancy, Service de Cardiologie, Institut Lorrain du Cœur et des Vaisseaux, Vandœuvre-lès-Nancy, France. Electronic address: c.suty-selton@chu-nancy.fr.
Christine
C
Selton-Suty
D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D064368:Healthy Volunteers; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016277:Ventricular Function, Left / Q000502:physiology*
3D strain; Echocardiography; Hypertrophic cardiomyopathy; Myocardial mass; Myocardial thickness