PMID- 24275954
OWN - NLM
STAT- MEDLINE
DCOM- 20140320
LR  - 20161125
IS  - 1942-0080 (Electronic)
IS  - 1941-9651 (Linking)
VI  - 7
IP  - 1
DP  - 2014 Jan
TI  - Investigation of global and regional myocardial mechanics with 3-dimensional 
      speckle tracking echocardiography and relations to hypertrophy and fibrosis in 
      hypertrophic cardiomyopathy.
PG  - 11-9
LID - 10.1161/CIRCIMAGING.113.000842 [doi]
AB  - BACKGROUND: In hypertrophic cardiomyopathy (HCM), heterogeneous myocardial 
      hypertrophy and fibrosis are responsible for abnormalities of left ventricular 
      (LV) function. We aimed to characterize LV global and regional myocardial 
      mechanics in HCM, according to segmental hypertrophy and fibrosis. METHODS AND 
      RESULTS: Fifty-nine patients with HCM underwent standard echocardiography, 
      3-dimensional speckle tracking echocardiography, and cardiac magnetic resonance 
      with late gadolinium enhancement (LGE); all 3 tests were <24 hours apart. 
      Longitudinal, circumferential, and area strains were investigated according to 
      the extent of LGE (no LGE, LGE<10%, and LGE>/=10%), segmental thickness (>/=15 versus 
      <15 mm), and segmental LGE (LGE versus non-LGE). Attenuated global longitudinal 
      strain showed association with extent of hypertrophy (indexed LV mass, r=0.32, 
      P=0.01; maximum LV wall thickness, r=0.34, P=0.009; number of segments>/=15 mm, 
      r=0.44, P<0.001), whereas enhanced global circumferential strain was correlated 
      to LV global functional parameters (indexed end-systolic volume, r=0.47, P<0.001; 
      ejection fraction, r=-0.75, P<0.001). Parameters of global myocardial mechanics 
      showed no association with the extent of LGE; in contrast, the extent of LGE was 
      associated with the extent of hypertrophy. All 3 deformation parameters were 
      attenuated both in segments>/=15 mm in thickness and in those with LGE; adjusted 
      analysis demonstrated that segmental presence of LGE was associated with 
      additional attenuation in myocardial deformation. CONCLUSIONS: Both hypertrophy 
      and fibrosis contribute to regional impairment of myocardial shortening in HCM. 
      The extent of hypertrophy is the primary factor altering global myocardial 
      mechanics. Circumferential myocardial shortening seems to be directly involved in 
      preservation of LV systolic performance in HCM.
FAU - Urbano-Moral, Jose Angel
AU  - Urbano-Moral JA
AD  - Hypertrophic Cardiomyopathy Center and Cardiovascular Imaging and Hemodynamic 
      Laboratory, Tufts Medical Center, Boston, MA.
FAU - Rowin, Ethan J
AU  - Rowin EJ
FAU - Maron, Martin S
AU  - Maron MS
FAU - Crean, Andrew
AU  - Crean A
FAU - Pandian, Natesa G
AU  - Pandian NG
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131125
PL  - United States
TA  - Circ Cardiovasc Imaging
JT  - Circulation. Cardiovascular imaging
JID - 101479935
RN  - 0 (Contrast Media)
RN  - K2I13DR72L (Gadolinium DTPA)
SB  - IM
MH  - Adult
MH  - Biomechanical Phenomena
MH  - Cardiomyopathy, Hypertrophic/*diagnostic imaging/pathology/physiopathology
MH  - Chi-Square Distribution
MH  - Contrast Media
MH  - *Echocardiography, Three-Dimensional
MH  - Female
MH  - Fibrosis
MH  - Gadolinium DTPA
MH  - Humans
MH  - Image Interpretation, Computer-Assisted
MH  - Linear Models
MH  - Magnetic Resonance Imaging, Cine
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - Myocardium/*pathology
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/pathology/physiopathology
MH  - *Ventricular Function, Left
OTO - NOTNLM
OT  - cardiomyopathy, hypertrophic
OT  - echocardiography
OT  - magnetic resonance imaging
EDAT- 2013/11/28 06:00
MHDA- 2014/03/22 06:00
CRDT- 2013/11/27 06:00
PHST- 2013/11/27 06:00 [entrez]
PHST- 2013/11/28 06:00 [pubmed]
PHST- 2014/03/22 06:00 [medline]
AID - CIRCIMAGING.113.000842 [pii]
AID - 10.1161/CIRCIMAGING.113.000842 [doi]
PST - ppublish
SO  - Circ Cardiovasc Imaging. 2014 Jan;7(1):11-9. doi: 10.1161/CIRCIMAGING.113.000842. 
      Epub 2013 Nov 25.