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Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy

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Abstract

We analyzed the waveform of systolic strain and strain-rate curves to find a characteristic left ventricular (LV) myocardial contraction pattern in patients with hypertrophic cardiomyopathy (HCM), and evaluated the utility of these parameters for the differentiation of HCM and LV hypertrophy secondary to hypertension (HT). From global strain and strain-rate curves in the longitudinal and circumferential directions, the time from mitral valve closure to the peak strains (T-LS and T-CS, respectively) and the peak systolic strain rates (T-LSSR and T-CSSR, respectively) were measured in 34 patients with HCM, 30 patients with HT, and 25 control subjects. The systolic strain-rate waveform was classified into 3 patterns (“V”, “W”, and “√” pattern). In the HCM group, T-LS was prolonged, but T-LSSR was shortened; consequently, T-LSSR/T-LS ratio was distinctly lower than in the HT and control groups. The “√” pattern of longitudinal strain-rate waveform was more frequently seen in the HCM group (74 %) than in the control (4 %) and HT (20 %) groups. Similar but less distinct results were obtained in the circumferential direction. To differentiate HCM from HT, the sensitivity and specificity of the T-LSSR/T-LS ratio <0.34 and the “√”-shaped longitudinal strain-rate waveform were 85 and 63 %, and 74 and 80 %, respectively. In conclusion, in patients with HCM, a reduced T-LSSR/T-LS ratio and a characteristic “√”-shaped waveform of LV systolic strain rate was seen, especially in the longitudinal direction. The timing and waveform analyses of systolic strain rate may be useful to distinguish between HCM and HT.

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Authors and Affiliations

  1. Faculty of Health Sciences, Hokkaido University, Kita-12, Nishi-5, Kita-ku, Sapporo, 060-0812, Japan

    Kazunori Okada, Sanae Kaga, Taisei Mikami & Nobuo Masauzi

  2. Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan

    Ayumu Abe

  3. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan

    Masahiro Nakabachi, Shinobu Yokoyama, Hisao Nishino, Ayako Ichikawa, Mutsumi Nishida & Chikara Shimizu

  4. Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan

    Daisuke Murai, Taichi Hayashi, Hiroyuki Iwano, Satoshi Yamada & Hiroyuki Tsutsui

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  1. Kazunori Okada
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  2. Sanae Kaga
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  3. Taisei Mikami
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  4. Nobuo Masauzi
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  5. Ayumu Abe
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  9. Ayako Ichikawa
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  11. Daisuke Murai
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  14. Hiroyuki Iwano
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  15. Satoshi Yamada
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  16. Hiroyuki Tsutsui
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Correspondence to Taisei Mikami.

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Okada, K., Kaga, S., Mikami, T. et al. Characteristic systolic waveform of left ventricular longitudinal strain rate in patients with hypertrophic cardiomyopathy. Heart Vessels 32, 591–599 (2017). https://doi.org/10.1007/s00380-016-0906-y

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  • DOI: https://doi.org/10.1007/s00380-016-0906-y

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