132 Longitudinal strain rate/strain and coronary flow velocity in patients with hypertrophic cardiomyopathy

2007 ◽  
Vol 6 (1) ◽  
pp. 33-33
Author(s):  
E PAVLYUKOVA ◽  
R KARPOV
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Strain Rate ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Longitudinal Strain ◽  
Coronary Flow Velocity ◽  
Longitudinal Strain Rate

scholarly journals P1594 Relationship between left ventricular morphology and systolic performance and coronary microcirculatory dysfunction in hypertrophic cardiomyopathy

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Aguiar Rosa ◽  
L Branco ◽  
A Galrinho ◽  
A Fiarresga ◽  
L Lopes ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Myocardial Ischemia ◽  
Coronary Flow ◽  
Longitudinal Strain ◽  
Global Longitudinal Strain ◽  
Left Ventricular ◽  
Coronary Flow Velocity ◽  
Microcirculatory Dysfunction ◽  
Maximal Wall Thickness ◽  
Systolic Performance

Abstract Background Myocardial ischemia constitutes one of the most important pathophysiological features in hypertrophic cardiomyopathy (HCM). Chronic and recurrent myocardial ischemia leads to fibrosis, which may culminate in myocardial dysfunction. Objective To analyse the relationship between left ventricular (LV) morphology and systolic performance and coronary microcirculatory dysfunction in HCM. Methods The present study prospectively included HCM patients (P) who underwent transthoracic echocardiography. Left ventricular (LV) function was evaluated by ejection fraction (LVEF), global longitudinal strain (GLS) and tissue Doppler septal and lateral s’. The evaluation of coronary flow velocity reserve (CFVR) was performed in apical three chambers view for the left anterior descending (LAD) artery and in an apical three chambers view for the posterior descending (PD) artery. Diastolic coronary flow velocity was measured in basal conditions and in hyperemia, induced by adenosine perfusion (0.14 mg/kg/min intravenously, during 2 minutes). Absolute CFVR was calculated as the ratio of hyperemic to basal peak diastolic flow velocities; relative CFVR was calculated as the ratio between CFVR LAD and CFVR PD. Results 23 P were enrolled (57% male, mean age 57.9 ± 13.7 years). Asymmetric septal hypertrophy was verified in 70% of P, with maximal wall thickness of 21.6 ± 4.3mm. Obstructive HCM was documented in 35% of patients. CFV was successfully measured in the LAD in all patients, but only in 70% of patients in the PD due to technical issues related to poor acoustic window and anatomical constraints. 78% of P (n = 18) presented CFVR <2, denoting microcirculatory dysfunction. Relative CFVR (LAD CFVR/ PD CFVR) was ≥1 in 43% of P. P with maximal wall thickness (MWT)>20mm presented higher CFV PD at baseline (46.5 ± 17.4 vs 32.5 ± 12.6 cm/s; p = 0.072), lower CFVR PD (1.3 ± 0.3 vs 2.5 ± 0.8; p = 0.003) and greater regional difference of microcirculation (relative CFVR 1.4 ± 0.6 vs 0.8 ± 0.3; p = 0.048). At baseline conditions, CFV LAD was higher in obstructive HCM (44.0 ± 4.8 vs 35.3 ± 10.6 cm/s; p = 0.040). P with impairment in global longitudinal strain (GLS>-18%) had higher basal CFV LAD (40.1 ± 8.6 vs 30.0 ± 12.2 cm/s; p = 0.059) and PD (44.5 ± 15.2 vs 20.0 ± 5.0 cm/s; p = 0.015) but lower CFVR PD (1.5 ± 0.5 vs 2.8 ± 1.1; p = 0.039). The reduction in CFVR PD was also noted in P with time to peak longitudinal strain dispersion >90mseg (CFVR PD 1.2 ± 0.2vs1.9 ± 0.9;p = 0.012). Conclusion Higher CFV at baseline was noted in P with greater MWT, obstructive HCM and worse GLS. Coronary microcirculatory dysfunction was associated with the degree of LV hypertrophy and impairment in LV systolic performance.

Prognostic role of coronary flow velocity reserve in hypertrophic cardiomyopathy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Tesic ◽  
Q Ciampi ◽  
A Djordjevic-Dikic ◽  
B Beleslin ◽  
L Cortigiani ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Flow Velocity ◽  
Wall Thickness ◽  
Coronary Flow ◽  
Multivariable Analysis ◽  
Coronary Microvascular Dysfunction ◽  
Coronary Flow Velocity Reserve ◽  
Coronary Flow Velocity ◽  
Maximal Wall Thickness

Abstract Background A reduction in coronary flow velocity reserve (CFVR) related to coronary microvascular dysfunction is a major mechanism for ischemia in hypertrophic cardiomyopathy (HCM). Hypothesis To assess the functional correlates and prognostic value of CFVR during stress echocardiography (SE) in HCM. Methods We enrolled 201 HCM patients (age 51±14 years, 105 male, 52%; maximal wall thickness: 18±3 mm) studied with CFVR during exercise (n=33, 16.4%), dipyridamole (n=89, 44.3%) or adenosine (n=79, 39.3%) SE in 6 certified centers. CFVR was assessed using pulsed wave Doppler sampling in left anterior descending coronary artery. All patients completed the clinical follow-up. Results During SE mean value of CFVR was 2.11±0.46. No patients showed regional wall motion abnormalities during stress. LV outflow tract obstruction (LVOTO) was present in 34 (16.9%) patients at rest and in 47 (23.4%) at peak stress. CFVR was inversely related to age (r=−0.229, p=0.001) and maximal wall thickness (r=−0.197, p=0.031). During a median follow-up of 26 months (IQ range: 12–48 months), 75 events in 63 patients occurred: 10 deaths, 33 new hospital admission for acute heart failure, 8 sustained ventricular tachycardias and 24 atrial fibrillations. Patients in the lowest tertile (≤1.88) showed the worse prognosis with higher incidence of follow-up events compared to median tertile (1.89–2.29) and highest tertile (≥2.30) (see figure). At multivariable analysis, NYHA functional class (HR: 2.234, 95% CI: 1.398–3.517, p=0.001), presence of LVOTO at rest (HR: 2.958, 95% CI: 1.074–3.570, p=0.028) and lowest tertile of CFVR (HR: 2.144, 95% CI: 1.126–4.081, p=0.011) were the independent predictors of follow-up events. Conclusions In HCM patients, reduction in CFVR is associated to a clearly worse outcome. The spectrum of prognostic stratification is expanded if the response is titrated according to a continuous scale. Figure 1 Funding Acknowledgement Type of funding source: None

Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy

2016 ◽  
Vol 32 (5) ◽  
pp. 591-599 ◽  
Author(s):  
Kazunori Okada ◽  
Sanae Kaga ◽  
Taisei Mikami ◽  
Nobuo Masauzi ◽  
Ayumu Abe ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Strain Rate ◽  
Longitudinal Strain ◽  
Left Ventricular ◽  
Longitudinal Strain Rate

P1827 Impact of coronary microcirculatory dysfunction in the impairment of left ventricular deformation parameters by 4D echocardiographic techniques in hypertrophic cardiomyopathy patients

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Aguiar Rosa ◽  
L Branco ◽  
A Galrinho ◽  
L Lopes ◽  
A Fiarresga ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Left Ventricular ◽  
Coronary Flow Velocity ◽  
Microcirculatory Dysfunction ◽  
Deformation Parameters ◽  
Baseline Conditions ◽  
The Impact ◽  
Area Strain

Abstract Background Coronary microvascular dysfunction has been described as an important pathophysiologic feature in hypertrophic cardiomyopathy (HCM). Objective To analyse the impact of coronary microcirculatory dysfunction on left ventricular (LV) deformation parameters obtained by 4D echocardiography in HCM. Methods HCM patients (P) prospectively underwent dedicated transthoracic echocardiogram for microcirculation study. The evaluation of coronary flow velocity reserve (CFVR) was performed in apical three chambers view for the left anterior descending (LAD) artery and in an apical two chambers view for the posterior descending (PD) artery. Diastolic coronary flow velocity (CFV) was measured at basal conditions and during hyperaemia, induced with adenosine perfusion (0.14 mg/kg/min intravenously, during 2 minutes). Absolute CFVR was calculated as the ratio of hyperaemic to basal peak diastolic flow velocities. By 4D TTE (GE E95 equipment) LV global longitudinal strain (GLS), global circumferential stain, global radial strain, area strain, twist and torsion were analysed. Results 23 P were enrolled (57% male, mean age 57.9 ± 13.7 years). Asymmetric septal hypertrophy was verified in 70% of patients, with maximal wall thickness of 21.6 ± 4.3mm. Obstructive HCM was documented in 35% of patients. CFV was successfully measured in the LAD in all patients, but only in 70% of patients in the PD due to technical issues related to poor acoustic window and anatomical constraints. 78% of P (n = 18) presented CFVR <2, denoting microcirculatory dysfunction. Relative CFVR (CFVR LAD / CFVR PD) was ≥1 in 43% of P. At baseline conditions, 4D GLS < -8% was associated with lower LAD flow (34.3 ± 8.3 vs 42.7 ± 9.7cm/s; p = 0.037), trend to lower PD flow (35.3 ± 17.8 vs 49.9 ±18.4 cm/s; p = 0.066). 4D GLS < -8% P presented higher CFVR PD (2.0 ± 0.8 vs 1.1 ± 0.2; p = 0.009), with no significant difference in CFVR LAD. Global circumferential stain <-13% seemed to be associated with lower basal CFV LAD (32.5 ± 8.8 vs 40.4 ± 9.5 cm/s; p = 0.089) and PD (29.8 ± 9.0 vs 45.6 ± 17.4 cm/s; p = 0.054). P with better global circumferential stain (<-13%) presented higher CFVR PD (2.3 ± 0.7 vs 1.4 ± 0.7; p = 0.005), as well as P with an area strain <-18% (CFVR PD 2.0 ± 0.8 vs 1.4 ± 0.8; p = 0.038). P with LV twist >4deg presented higher CFV PD at baseline (49.6 ± 16.5 vs 33,8 ± 12.9 cm/s; p = 0.039) and during hyperemia (68.0 ± 12.2 vs 52.9 ± 12.1cm/s; p = 0.032). Conclusion HCM P with greater impairment in LV deformation parameters by 4D echocardiography presented increased basal diastolic CFV, which can be explained by increased coronary vascular resistance and a higher oxygen demand at baseline conditions. Worse LV performance was also associated with decreased CFVR, mainly in PD.

Sign in / Sign up

Export Citation Format

Share Document