Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study
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ORIGINAL PAPER
Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study based on layer‑specific speckle tracking echocardiaography Wen Liu1 · Yanfen Zhang1 · Yan Liu1 · Chunyan Ma1 · Jun Yang1 · Dandan Sun1 Received: 24 February 2020 / Accepted: 15 June 2020 © Springer Nature B.V. 2020
Abstract We conducted this study to investigate left ventricle (LV) systolic function in endocardial, mid-myocardial, and epicardial layers by two-dimensional (2D) speckle tracking echocardiography (STE) in hypertrophic cardiomyopathy (HCM) patients with myocardial injury indexed by elevated serum cardiac troponin I (cTnI). Twenty-nine HCM patients with myocardial injury, thirty-five HCM patients without myocardial injury, and ninty-one healthy controls were enrolled in this study. Serum cTnI > 0.026 ng/mL was defined as myocardial injury. LV longitudinal and circumferential strain (LS and CS) were assessed in endocardial, mid-myocardial and epicardial layers. Layer-specific LS and CS differed significantly (all P 50% of luminal stenosis in at least one major coronary vessel based on the result of coronary angiography or coronary CT angiography), chronic kidney disease, and diabetes mellitus. The healthy controls had no evidence or family history of HCM or other disease. Ethics approval was obtained from the Institutional Ethics Committee of China Medical University. Each participant provided written informed consent after receiving a detailed description of the study.
Conventional echocardiography All participants underwent echocardiographic examinations within 24 h after serum cTnI measurements. Optimal images were obtained using a Vivid 7 Dimension
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The International Journal of Cardiovascular Imaging
ultrasound system (GE Healthcare, Waukesha, WI) equipped with a 2- to 4-MHz phased-array transducer. Conventional 2D and tissue Doppler parameters were measured according to recommendations of the American Society of Echocardiography. LV end-diastolic dimension (LVEDD) and segmental thickness at 16 segments were measured at the end of the LV diastolic phase, while the left atrium (LA) anterior–posterior dimension was measured at the end of the LV systolic phase. The maximal wall thickness (MWT) was defined as the largest segmental thickness. Peak early and late diastolic mitral inflow velocities (E and A) were recorded in the apical fourchamber image by pulsed-wave Doppler. Resting peak LV outflow tract (LVOT) velocity was recorded from an apical five-chamber view by continuous-wave Doppler, yielding the maximal LVOT pressure gradient with simplified Bernoulli equation. Mitral regurgitation (MR) was qualitatively graded as none/trivial (0), mild (1), moderate (2), or severe (3). The ejection fraction (EF) was evaluated by Simpson’s modified biplane method from apical four- and two-chamber views. Early diastolic velocities (E′) of the mitral annulus were obtained from both septal and lateral sides. Mitral E/A and E/E′ values were calculated.
Speckle tracking ech
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