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Heart and Vessels

, Volume 33, Issue 9, pp 1046–1051 | Cite as

2D speckle-tracking TTE-based quantitative classification of left ventricular myocardium in patients with hypertrophic cardiomyopathy by the presence or the absence of fibrosis and/or hypertrophy

  • Nobusada Funabashi
  • Hiroyuki Takaoka
  • Koya Ozawa
  • Masae Uehara
  • Issei Komuro
  • Yoshio Kobayashi
Original Article
  • 60 Downloads

Abstract

We used peak longitudinal strain (PLS) on TTE in HCM patients to differentiate LV myocardium (LVM) into the following 4 groups: group 1—no fibrosis or hypertrophy (≥ 13 mm), group 2—no fibrosis but hypertrophy evident, group 3—fibrosis present but without hypertrophy, and group 4—both fibrosis and hypertrophy. Seventeen HCM patients (13 males, 56 ± 16 years) underwent both 1.5 T CMR and TTE. On TTE, PLS (absolute values) for each LVM segment from 17 AHA-defined lesions was calculated. Of 289 LVM lesions, the numbers in each group, 1–4, were 156, 53, 39, and 41, respectively. PLS for LVM segments in group 1 (13.6 ± 6.4%) were significantly greater than those in group 2 (8.5 ±  4.9%, P < 0.001), group 3 (10.4 ± 5.0%, P = 0.006), and group 4 (7.1 ± 4.4%, P < 0.001). PLS for LVM segments in group 3 was significantly greater than those in group 4 (P = 0.016). However, significant differences in PLS in LVM between groups 2 and 3, and between 2 and 4 were not observed. Using regional PLS, we demonstrate successful differentiation of LVM in HCM patients for group 1 (LVM with zero fibrosis or hypertrophy) from LVM belonging to groups 2–4 and we also demonstrate successful differentiation of LVM with fibrosis present but without hypertrophy from LVM with both fibrosis and hypertrophy. However, it is not possible to differentiate between LVM with no fibrosis but hypertrophy evident and those with fibrosis present but without hypertrophy and also between LVM with no fibrosis but hypertrophy evident and those with both fibrosis and hypertrophy. Our findings have significant implications for the management of HCM patients.

Keywords

Left ventricular myocardium Hypertrophic cardiomyopathy Fibrosis Hypertrophy Peak longitudinal strain Speckle-tracking transthoracic echocardiography Late enhancement Magnetic resonance imaging 

Notes

Acknowledgements

This work is partially supported by a Grant from Japan Heart Foundation Research Grant (no Grant numbers). The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the Heart and Vessels.

Compliance with ethical standards

Conflict of interest

There is no conflict of interest to declare.

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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Nobusada Funabashi
    • 1
  • Hiroyuki Takaoka
    • 1
  • Koya Ozawa
    • 1
  • Masae Uehara
    • 2
  • Issei Komuro
    • 2
  • Yoshio Kobayashi
    • 1
  1. 1.Department of Cardiovascular MedicineChiba University Graduate School of MedicineChibaJapan
  2. 2.Department of Cardiovascular MedicineGraduate School of Medicine, The University of TokyoTokyoJapan

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