PMID- 30488501 OWN - NLM STAT- MEDLINE DCOM- 20190503 LR - 20190503 IS - 1540-8175 (Electronic) IS - 0742-2822 (Linking) VI - 36 IP - 1 DP - 2019 Jan TI - Myocardial constructive work is impaired in hypertrophic cardiomyopathy and predicts left ventricular fibrosis. PG - 74-82 LID - 10.1111/echo.14210 [doi] AB - BACKGROUND: The estimation of myocardial work by pressure strain loops (PSLs) is a totally new non-invasive approach to assess myocardial performance, and its role in patients with hypertrophic cardiomyopathy is unknown. The aims of the present study are therefore: (a) to compare myocardial work in patients with non-obstructive hypertrophic cardiomyopathy (HCM) and in a subset of age-matched healthy controls and (b) to assess the correlation between myocardial work and left ventricular (LV) fibrosis. DESIGN: Eighty-two patients with non-obstructive HCM (58 +/- 14 years) and 20 age-matched healthy subjects (58 +/- 7 years, P = 0.99) underwent standard and speckle-tracking echocardiography to assess myocardial dimensions and deformation parameters. PSLs analysis was used to estimate global myocardial constructive work (GCW) and wasted work (GWW). LV fibrosis was estimated at cardiac magnetic resonance (CMR) by qualitative assessment of late gadolinium enhancement (LGE), and significant fibrosis was defined as LGE in >/=2 LV segments. RESULTS: Global constructive work (1599 +/- 423 vs 2248 +/- 249 mm Hg%, P < 0.0001) was significantly reduced in HCM compared to the control group. No difference was observed in GWW (141 +/- 125 vs 101 +/- 88 mm Hg%, P = 0.18) and LV ejection fraction (LVEF) (63 +/- 13 vs 66 +/- 4% P = 0.17) between the two groups. In HCM, GCW was the only predictor of LV fibrosis at multivariable analysis (OR 1.01, 95% CI: 0.99-1.08, P = 0.04). A cutoff value of 1623 mm Hg% (AUC 0.80, 95% CI: 0.66-0.93, P < 0.0001) was able to predict myocardial fibrosis with a good sensitivity and fair specificity (82% and 67%, respectively). CONCLUSIONS: Global constructive work is significantly reduced in HCM despite normal LVEF and is associated with the LV fibrosis as assessed by LGE. CI - (c) 2018 Wiley Periodicals, Inc. FAU - Galli, Elena AU - Galli E AUID- ORCID: 0000-0001-9584-5505 AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Vitel, Emilie AU - Vitel E AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Schnell, Frederic AU - Schnell F AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Le Rolle, Virginie AU - Le Rolle V AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Hubert, Arnaud AU - Hubert A AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Lederlin, Mathieu AU - Lederlin M AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. FAU - Donal, Erwan AU - Donal E AUID- ORCID: 0000-0002-9083-1582 AD - University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, Rennes, France. LA - eng PT - Journal Article DEP - 20181129 PL - United States TA - Echocardiography JT - Echocardiography (Mount Kisco, N.Y.) JID - 8511187 SB - IM MH - Cardiomyopathy, Hypertrophic/*complications/diagnostic imaging/*physiopathology MH - Echocardiography/*methods MH - Exercise Test/statistics & numerical data MH - Female MH - Fibrosis MH - Heart Ventricles/*pathology MH - Humans MH - Magnetic Resonance Imaging MH - Male MH - Middle Aged MH - Myocardium/pathology MH - Sensitivity and Specificity MH - Ventricular Dysfunction/*complications/*pathology OTO - NOTNLM OT - cardiac magnetic resonance imaging OT - hypertrophic cardiomyopathy OT - myocardial strain EDAT- 2018/11/30 06:00 MHDA- 2019/05/06 06:00 CRDT- 2018/11/30 06:00 PHST- 2018/08/20 00:00 [received] PHST- 2018/10/19 00:00 [revised] PHST- 2018/10/20 00:00 [accepted] PHST- 2018/11/30 06:00 [pubmed] PHST- 2019/05/06 06:00 [medline] PHST- 2018/11/30 06:00 [entrez] AID - 10.1111/echo.14210 [doi] PST - ppublish SO - Echocardiography. 2019 Jan;36(1):74-82. doi: 10.1111/echo.14210. Epub 2018 Nov 29.