In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

This content is currently on FREE ACCESS, enjoy another 18 days of free consultation

In these unprecedented times, the ESC is doing everything it can to support its community: FREE access to all ESC 365 content until 31 July: explore more than 125,000 educational resources.

From 1 August onwards, support our mission by becoming a member.

Left heart study based on left atrial and left ventricle three-dimensional speckle tracking deformation in hypertrophic cardiomyopathy and hypertrophic cardiomyopathy genotipe positive and fenotipe

Session Poster session 5

Speaker Giuseppe Esposito

Event : EuroEcho 2018

  • Topic : imaging
  • Sub-topic : 3D Echocardiography
  • Session type : Poster Session

Authors : G Esposito (Rome,IT), P Piras (Rome,IT), A Evangelista (Rome,IT), L Teresi (Rome,IT), PE Puddu (Rome,IT), C Torromeo (Rome,IT)

G Esposito1 , P Piras2 , A Evangelista3 , L Teresi4 , PE Puddu4 , C Torromeo4 , 1Umberto I Polyclinic of Rome - Rome - Italy , 2UniversitÇÿ Rome Tre - Rome - Italy , 3Giovanni Calibita Fatebenefratelli Hospital - Rome - Italy , 4Sapienza University of Rome - Rome - Italy ,

European Heart Journal - Cardiovascular Imaging ( 2019 ) 20 ( Supplement 1 ), i1092

Background: Hypertrophic Cardiomyopathy (HCM) is one of the most prevalent heart diseases among those genetically determined. Whereas HCM impact on left ventricle (LV) is largely studied, investigations in HCM with genotipe positive and fenotipe negative (HCMG+P-) are less common, especially on left atrium (LA) . 
Purpose: This study evaluated the left heart (LH) function such as LA and LV deformation separately using 3DSTE in C, HCM and HCMG+P- patients. To assess pathophysiological consequences of HCM condition on LH , we investigated the impact of the genetic mutations on LH functioning in patients who have no clinical symptoms or structural abnormalities based on 2D echocardiography.
Methods: We enrolled 82 C, 25 HCM and 11 HCMG+P- patients; 20 subjects in HCM group had an obstructive sub-aortic gradient (SUB_AO). 2D and 3DSTE echocardiography were performed sequentially, and for the latters we acquired LA and the corresponding LV, for each subject in the same clip. In the first part of the study we assessed LA and LV mechanical remodeling only in C and HCM, then in the second step we included also HCMG+P-. 3DSTE evaluated the peak and the time to peak of longitudinal (GLS,GLPDS) circumferential (GCS,GCPDS) and radial strain (GRS,GRPDS) during systolic phase for LV and in diastolic phase for LA. GRS was not acquired for LA because his thickness wall is too small. In order to define the correlation among structural remodeling and impaired function, we correlated 2D parameters with 3DSTE.
Results: Concerning 2D parameters we found dilated LAVi, higher LVMASSi and increased E/e' ratio in HCM compared with C; when we included also HCMG+P-, we found the same results. 3DSTE variables showed impaired GLS and GCS in HCM for both LV and LA analysis and GRS only for LV; also GLPDS was increased in HCM subject. At pairwise analysis, GLS and GLPDS were in agreement to demonstrate normal deformation in HCMG+P- (similar with C)  (see Figure 1). We also found a correlation among 3DSTE, LVMASSi, E/e' ratio and LAVi (GLS: vs LVMASSi ? 0.381; vs LAVi ? -0.446; vs E/e' ? 0.312; GLPDS: vs LVMASSi ? 0.338), whereas a positive association among 2D parameters and SUB_AO (SUB_AO: vs LVMASSi ? 0.593; vs LAVi ? 0.580; E/e': vs LVMASSi ? 0.513; vs LAVi ? 0.534). Increased LVMASSi might determine poor LV compliance with the development of diastolic dysfunction and finally increased LAVi; on the other hand, the presence of SUB_AO contributed to LH remodeling by determining higher LV pressures. These alterations might impact significantly on LH mechanical properties as detected by impaired 3DSTE parameters and may underline the relation between LH remodeling and reduced 3D strain.
Conclusions: Main findings concern normal LH deformation in HCMG+P-despite the genetic mutations, and impaired deformation in HCM group compared to C; in particular, reduced strain were found both in LA and LV as a marker of worst mechanical remodeling with evidence of correlation with GLS and GCS.

Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from general ESC events 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are