Abstract
Hypertrophic cardiomyopathy (HCM) affects the right ventricle (RV) because of the anatomically hypertrophied septum and plausibly by extension of the myopathic process to the RV. We sought to investigate RV strain in patients with left ventricular hypertrophy secondary to either HCM or hypertension (H-LVH). Our cross-sectional study included 32 patients with HCM, 21 patients with H-LVH, and 11 healthy subjects, who were evaluated with transthoracic echocardiography. Using a dedicated software package, bi-dimensional acquisitions were analyzed to measure segmental longitudinal strain in apical views. Right ventricular global longitudinal strain (GLS) was calculated by averaging septal and right free wall strains. The HCM and H-LVH groups were comparable for age and demographic characteristics. Right ventricular tricuspid annular plane systolic excursion was not significantly different between HCM and H-LVH subjects. Moreover, RV GLS, septal and lateral RV myocardial strain were significantly impaired in patients with HCM (all p < 0.001). Regional and global RV strain parameters were not significantly impaired in H-LVH compared to healthy controls An RV GLS cut-off value of >14.9 % differentiated HCM and H-LVH with a 90 % sensitivity and a 95 % specificity (p < 0.001). RV strain parameters are impaired in patients with HCM. Assessment of two-dimensional RV strain parameters could help differentiate between HCM and H-LVH.
Similar content being viewed by others
References
Maron BJ (1997) Hypertrophic cardiomyopathy. Lancet 350(9071):127–133
D’Andrea A, Caso P, Severino S, Sarubbi B, Forni A, Cice G et al (2003) Different involvement of right ventricular myocardial function in either physiologic or pathologic left ventricular hypertrophy: a Doppler tissue study. J Am Soc Echocardiogr 16(2):154–161
Efthimiadis GK, Parharidis GE, Karvounis HI, Gemitzis KD, Styliadis IH, Louridas GE (2002) Doppler echocardiographic evaluation of right ventricular diastolic function in hypertrophic cardiomyopathy. Eur J Echocardiogr 3(2):143–148
Maron MS, Hauser TH, Dubrow E, Horst TA, Kissinger KV, Udelson JE et al (2007) Right ventricular involvement in hypertrophic cardiomyopathy. Am J Cardiol 100(8):1293–1298
Morner S, Lindqvist P, Waldenstrom A, Kazzam E (2008) Right ventricular dysfunction in hypertrophic cardiomyopathy as evidenced by the myocardial performance index. Int J Cardiol 124(1):57–63
McKenna WJ, Kleinebenne A, Nihoyannopoulos P, Foale R (1988) Echocardiographic measurement of right ventricular wall thickness in hypertrophic cardiomyopathy: relation to clinical and prognostic features. J Am Coll Cardiol 11(2):351–358
Sengupta PP, Mehta V, Mohan JC, Arora R, Khandheria BK (2004) Regional myocardial function in an arrhythmogenic milieu: tissue velocity and strain rate imaging in a patient who had hypertrophic cardiomyopathy with recurrent ventricular tachycardia. Eur J Echocardiogr. 5(6):438–442
Sun JP, Stewart WJ, Yang XS, Donnell RO, Leon AR, Felner JM et al (2009) Differentiation of hypertrophic cardiomyopathy and cardiac amyloidosis from other causes of ventricular wall thickening by two-dimensional strain imaging echocardiography. Am J Cardiol 103(3):411–415
Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R et al (2006) Global and regional myocardial function quantification by two-dimensional strain: application in hypertrophic cardiomyopathy. J Am Coll Cardiol 47(6):1175–1181
Kato TS, Noda A, Izawa H, Yamada A, Obata K, Nagata K et al (2004) Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation 110(25):3808–3814
Yang H, Sun JP, Lever HM, Popovic ZB, Drinko JK, Greenberg NL et al (2003) Use of strain imaging in detecting segmental dysfunction in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 16(3):233–239
Richand V, Lafitte S, Reant P, Serri K, Lafitte M, Brette S et al (2007) An ultrasound speckle tracking (two-dimensional strain) analysis of myocardial deformation in professional soccer players compared with healthy subjects and hypertrophic cardiomyopathy. Am J Cardiol 100(1):128–132
Saghir M, Areces M, Makan M (2007) Strain rate imaging differentiates hypertensive cardiac hypertrophy from physiologic cardiac hypertrophy (athlete’s heart). J Am Soc Echocardiogr 20(2):151–157
D’Andrea A, Caso P, Bossone E, Scarafile R, Riegler L, Di Salvo G et al (2010) Right ventricular myocardial involvement in either physiological or pathological left ventricular hypertrophy: an ultrasound speckle-tracking two-dimensional strain analysis. Eur J Echocardiogr. 11(6):492–500
Zemanek D, Tomasov P, Prichystalova P, Linhartova K, Veselka J (2010) Evaluation of the right ventricular function in hypertrophic obstructive cardiomyopathy: a strain and tissue Doppler study. Physiol Res 59(5):697–702
Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS et al (2011) 2011 ACCF/AHA Guideline for the Diagnosis and Treatment of Hypertrophic Cardiomyopathy: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Developed in collaboration with the American Association for Thoracic Surgery, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 58(25):e212–e260
Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K et al (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23(7):685–713 (quiz 86–88)
Severino S, Caso P, Cicala S, Galderisi M, de Simone L, D’Andrea A et al (2000) Involvement of right ventricle in left ventricular hypertrophic cardiomyopathy: analysis by pulsed Doppler tissue imaging. Eur J Echocardiogr 1(4):281–288
Pagourelias ED, Efthimiadis GK, Parcharidou DG, Gossios TD, Kamperidis V, Karoulas T et al (2011) Prognostic value of right ventricular diastolic function indices in hypertrophic cardiomyopathy. Eur J Echocardiogr 12(11):809–817
Hartlage GR, Kim JH, Strickland PT, Cheng AC, Ghasemzadeh N, Pernetz MA et al (2015) The prognostic value of standardized reference values for speckle-tracking global longitudinal strain in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 31(3):557–565
Reant P, Donal E, Schnell F, Reynaud A, Daudin M, Pillois X et al (2015) Clinical and imaging description of the Maron subtypes of hypertrophic cardiomyopathy. Int J Cardiovasc Imaging 31(1):47–55
Afonso L, Kondur A, Simegn M, Niraj A, Hari P, Kaur R et al (2012) Two-dimensional strain profiles in patients with physiological and pathological hypertrophy and preserved left ventricular systolic function: a comparative analyses. BMJ Open 2(4). doi:10.1136/bmjopen-2012-001390
Voigt JU, Pedrizzetti G, Lysyansky P, Marwick TH, Houle H, Baumann R et al (2015) Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/industry task force to standardize deformation imaging. J Am Soc Echocardiogr 28(2):183–193
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Rights and permissions
About this article
Cite this article
Afonso, L., Briasoulis, A., Mahajan, N. et al. Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging: a cross-sectional study. Int J Cardiovasc Imaging 31, 1503–1509 (2015). https://doi.org/10.1007/s10554-015-0722-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10554-015-0722-y