Myocardial Shortening in 3 Orthogonal Directions and Its Transmural Variation in Patients With Nonobstructive Hypertrophic Cardiomyopathy

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  • Okada Kazunori
    Faculty of Health Sciences, Hokkaido University
  • Yamada Satoshi
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Iwano Hiroyuki
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Nishino Hisao
    Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
  • Nakabachi Masahiro
    Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
  • Yokoyama Shinobu
    Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
  • Abe Ayumu
    Faculty of Health Sciences, Hokkaido University
  • Ichikawa Ayako
    Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
  • Kaga Sanae
    Faculty of Health Sciences, Hokkaido University
  • Nishida Mutsumi
    Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital
  • Hayashi Taichi
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Murai Daisuke
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine
  • Mikami Taisei
    Faculty of Health Sciences, Hokkaido University
  • Tsutsui Hiroyuki
    Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine

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Abstract

Background:Although longitudinal strain (LS) is known to be reduced in patients with hypertrophic cardiomyopathy (HCM), it has not been elucidated whether or not circumferential strain (CS) is reduced. We aimed to determine whether multidirectional and layer-specific myocardial strain is reduced in patients with nonobstructive HCM.Methods and Results:Speckle-tracking echocardiography was performed in 41 HCM patients and 27 control subjects. Segmental and global LS and CS were measured in the inner, mid, and outer layers. Global LS was significantly lower in the HCM group than in controls in the inner (−10.3±2.9 vs. −14.8±2.0%, P<0.001), mid (−8.7±2.6 vs. −13.8±1.9%, P<0.001), and outer (−7.2±2.6 vs. −11.9±1.9%, P<0.001) layers. Global CS was preserved in the inner layer (−23.8±4.7 vs. −24.3±3.3%, P=0.69) but reduced in the mid (−10.3±3.1 vs. −13.3±2.5%, P<0.001) and outer layers (−6.7±2.3 vs. −8.6±2.3%, P=0.002). Differences in CS between the inner and outer layers correlated with segmental relative wall thickness (r=−0.20, P=0.002). Furthermore, only the absolute value of global CS in the inner layer positively correlated with left ventricular ejection fraction (r=0.32, P<0.01) among these multidirectional and layer-specific strains.Conclusions:In patients with HCM, not only the LS in all layers but also CS in the mid and outer layers was reduced, presumably reflecting impaired myocardial function. In contrast, CS in the inner layer was preserved, being associated with maintenance of chamber function. (Circ J 2015; 79: 2471–2479)

Journal

  • Circulation Journal

    Circulation Journal 79 (11), 2471-2479, 2015

    The Japanese Circulation Society

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