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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

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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.

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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.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan

    Nobusada Funabashi, Hiroyuki Takaoka, Koya Ozawa & Yoshio Kobayashi

  2. Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

    Masae Uehara & Issei Komuro

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  1. Nobusada Funabashi
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  2. Hiroyuki Takaoka
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  3. Koya Ozawa
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  4. Masae Uehara
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  5. Issei Komuro
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  6. Yoshio Kobayashi
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Correspondence to Nobusada Funabashi.

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Funabashi, N., Takaoka, H., Ozawa, K. et al. 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. Heart Vessels 33, 1046–1051 (2018). https://doi.org/10.1007/s00380-018-1155-z

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  • DOI: https://doi.org/10.1007/s00380-018-1155-z

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