Three-dimensional speckle tracking echocardiography for the preclinical diagnosis of hypertrophic cardiomyopathy

Abstract

The aim is to detect early changes in myocardial mechanics in hypertrophic cardiomyopathy (HCM) mutation carriers, three-dimensional speckle tracking echocardiography (3DSTE) was used for screening of family members in the HCM population. Eighty subjects were divided as: HCM mutation carriers (n = 23), manifest HCM patients (n = 28), and normal controls (n = 29). They prospectively underwent 3DSTE for left atrial (LA) and left ventricle (LV) strain analysis. HCM mutation carriers showed significantly higher LA minimum volume (ml/m(2)) (17 ± 6 vs. 14 ± 4, respectively, P = 0.03) and a significantly lower peak atrial longitudinal strain (PALS) (%), (27 ± 5 vs. 31 ± 7, respectively, P = 0.02) when compared to controls. However, no differences were found in global or regional LV systolic myocardial deformation between both groups. Manifest HCM patients, compared to carriers showed significantly higher LA minimum (27 ± 10 vs. 17 ± 6, respectively, P < 0.001) and maximum volume (42 ± 14 vs. 32 ± 8, respectively, P = 0.007) as well as lower LA ejection fraction (%) (35 ± 8 vs. 47 ± 9, respectively, P < 0.001) and PALS (17 ± 5 vs. 27 ± 5, respectively, P < 0.001). Comparing LV strain, HCM patients showed reduced global longitudinal (-11 ± 4 vs. -16 ± 3, respectively, P < 0.001) and area strain (-35 ± 6 vs. -40 ± 5, respectively, P = 0.005). HCM mutation carriers may be distinguished from healthy subjects using 3DSTE through detection of LA dysfunction that may indicate LV diastolic dysfunction. Further research in a larger study population with gene-specific analysis is warranted for potential clinical usefulness of 3DSTE in family screening for HCM.

Echocardiographic advances in hypertrophic cardiomyopathy: Three‐dimensional and strain imaging echocardiography

“…3DSTE was used for screening family members in the HCM population to early detect myocardial change in HCM mutation carriers. 60 LA minimum volume and lower peak atrial longitudinal strain were observed in mutations carriers compared to controls.…”

“…3DSTE was used for screening family members in the HCM population to early detect myocardial change in HCM mutation carriers …”

Diastolic Dysfunction of Hypertrophic Cardiomyopathy Genotype‐Positive Subjects Without Hypertrophy Is Detected by Tissue Doppler Imaging: A Systematic Review and Meta‐analysis

“…The 12 included studies for meta‐analysis covered years 2001 to 2015, regions including America, Europe and Asia, and mean age from 9.8 to 55.0. The G+/LVH− and control groups contained 302 and 349 subjects, respectively.…”

Strain Imaging

“…In a study of STE by Aly et al, 71 manifest HCM patients showed reduced GLS (−11 ± 4 vs −16 ± 3, respectively, P < 0.001) and area strain (−35 ± 6 vs −40 ± 5, respectively, P = 0.005) compared with controls. Serri et al 72 In summary, STE in obstructive HCM facilitates detection of subclinical systolic dysfunction in focal areas of pathological myocardial hypertrophy.…”