Purpose: To assess the myocardial strain in children with hypertrophic cardiomyopathy (HCM). Methods: A total of 61 patients aged between 7 and 17 years with an asymmetric form of HCM underwent an ultrasound examination of the heart using standard techniques. An assessment of the left ventricular systolic function was performed using the two-dimensional (2D) speckle-tracking mode with analysis parameters that included global and segmental longitudinal, circumferential, and radial myocardial strains. Strain data for the subendocardial and subepicardial layers for each segment of the left ventricle, as well as their total values, were determined. Results: Global longitudinal strain and longitudinal strain rate were dec reased due to the impaired contractility of hypertrophied myocardial segments in 100% of cases of non-obstructive and obstructive HCM forms. A decrease in global, radial, and circumferential strain parameters and their rates has been observed in all children with an obstructive form of HCM and 39 (86.6%) patients with non-obstructive form. At the same time, there was a statistically significant difference between strains and strain rates in children with a non-obstructive form of HCM in comparison to those with an obstructive form of the disease. Conclusion: Changes in myocardial strains observed using the 2D speckle-tracking mode in children with HCM indicate early systolic dysfunction of the left ventricle. Longitudinal strain was the most sensitive compared to radial and circumferential types. It was statistically significantly different in children with an obstructive form of HCM compared to those with non-obstructive form of the disease. These results are important for early therapy initiation and, therefore, may improve prognosis in children with HCM.
Purpose: This article is about an unusual clinical case of a 14-year-old boy with hypertrophic cardiomyopathy (HCM).Ejection fraction (EF) and shortening fraction (FS) of the left ventricle in children with HCM remain within a normal range for an extended period of time. Therefore, detection of a decrease in segmental myocardial contractility at the initial stage of the disease presents a diagnostic problem. Methods: The clinical characteristics of the patient, study results, and analysis of the left ventricular myocardial strain using 2D speckle-tracking mode in an echocardiographic examination are presented. Results: A decrease in strain indicators in the anterioseptal, anterior, and anterolateral segments of the left ventricular myocardium and a compensatory increase in the contralateral segments were revealed. This served as an indication to start treatment. Conclusions: A decrease in strain indicators in the 2D speckle- tracking mode is most informatively represented by changes in segmental systolic function of the left ventricle at the initial stage of HCM.
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