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- Title
Myocardial Fibrosis Is Associated with Biventricular Dysfunction in Patients with Hypertrophic Cardiomyopathy.
- Authors
Prinz, Christian; van Buuren, Frank; Faber, Lothar; Bitter, Thomas; Bogunovic, Nikola; Burchert, Wolfgang; Horstkotte, Dieter
- Abstract
Aims: To assess left (LV) and right ventricular (RV) function by two-dimensional (2D) speckle tracking echocardiography and its relation to myocardial fibrosis in hypertrophic cardiomyopathy (HCM). Methods: We enrolled 50 HCM patients (30 male; 47.3 ± 9.9 years) in our study. Each patient received echocardiography with modern high-end scanners. For speckle tracking analysis of LV and RV function the dedicated software was used. The presence of myocardial fibrosis was detected by cardiac magnetic resonance imaging (MRI). Results: For intraobserver variability of RV global longitudinal strain, we found a correlation of r = 0.89 (p < 0.001) with a minor bias of 4.9 ± 2.9%. On cardiac MRI 30 patients (60%) demonstrated late gadolinium-enhancement (LGE) of the LV. Of these patients only 7% showed LGE of the RV. HCM patients with myocardial fibrosis had less global longitudinal LV strain in comparison to patients without myocardial fibrosis (−12.8 ± 2.2 vs −21.1 ± 2.6, P < 0.001), thicker interventricular septums (23.7 ± 4.0 vs 19.2 ± 5.1, P < 0.001), larger left atria (34.9 ± 7.1 vs 23.9 ± 5.1, P < 0.001), and impaired diastolic function (E/A-ratio: 1.02 ± 0.22 vs 1.15 ± 0.18, P < 0.01). Comparable results were found for RV function. LV and RV strain correlated with r = 0.85 (p < 0.001). Conclusions: HCM is not only a disease of the LV. LGE in HCM is associated with both LV and RV dysfunction. Although RV LGE occurs only in a minority of patients with HCM and LV fibrosis, speckle tracking echocardiography is feasible for evaluating LV and RV dysfunction in these patients. (Echocardiography 2012;29:438-444)
- Subjects
HYPERTROPHIC cardiomyopathy; HEART ventricle diseases; STATISTICAL correlation; DOPPLER echocardiography; ECHOCARDIOGRAPHY; LEFT heart ventricle; RIGHT heart ventricle; MAGNETIC resonance imaging; MULTIVARIATE analysis; REGRESSION analysis; RESEARCH evaluation; STATISTICAL hypothesis testing; STATISTICS; T-test (Statistics); DATA analysis; FIBROSIS; VALSALVA'S maneuver; DATA analysis software; DESCRIPTIVE statistics; DISEASE complications
- Publication
Echocardiography, 2012, Vol 29, Issue 4, p438
- ISSN
0742-2822
- Publication type
Article
- DOI
10.1111/j.1540-8175.2011.01588.x