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Heterogeneity of regional systolic function detected by tissue doppler imaging is linked to impaired global left ventricular relaxation in hypertrophic cardiomyopathy
  1. Tomoko Sugiyama Kato (rinnko{at}sannet.ne.jp)
  1. National Cardiovascular Center, Japan
    1. Hideo Izawa (izawa{at}med.nagoya-u.ac.jp)
    1. Nagoya University Graduate School of Medicine, Japan
      1. Kazuo Komamura (kkoma{at}hsp.ncvc.go.jp)
      1. National Cardiovascular Center, Japan
        1. Akiko Noda (a-noda{at}met.nagoya-u.ac.jp)
        1. Nagoya University School of Health Sciences, Japan
          1. Hiroyuki Asano (asano-h{at}med.nagoya-u.ac.jp)
          1. Nagoya University Graduate School of Medicine, Japan
            1. Kohzo Nagata (nagata{at}met.nagoya-u.ac.jp)
            1. Nagoya University School of Health Sciences, Japan
              1. Shuji Hashimoto
              1. National Cardiovascular Center, Japan
                1. Noboru Oda (odanoboru{at}mail.goo.ne.jp)
                1. National Cardiovascular Center, Japan
                  1. Chizuko Kamiya (chiz{at}hsp.ncvc.go.jp)
                  1. Nagoya University Graduate School of Medicine, Japan
                    1. Hideaki Kanzaki (kanzakih{at}hsp.ncvc.go.jp)
                    1. National Cardiovascular Center, Japan
                      1. kazuhiko Hashimura (hashimu{at}hsp.ncvc.go.jp)
                      1. National Cardiovascular Center, Japan
                        1. Takeshi Nakatani
                        1. National Cardiovascular Center, Japan
                          1. Hatsue Ishibashi Ueda
                          1. National Cardiovascular Center, Japan
                            1. Toyoaki Murohara (murohara{at}med.nagoya-u.ac.jp)
                            1. Nagoya University Graduate School of Medicine, Japan
                              1. Masafumi Kitakaze (kitakaze{at}zf6.so-net.ne.jp)
                              1. National Cardiovascular Center, Japan
                                1. Mistuhiro Yokota (mitsuhiro.yokota{at}theranos-inst.com)
                                1. Aichi-Gakuin University, School of Dentistry, Japan

                                  Abstract

                                  Objective To evaluate regional and global left ventricular (LV) function and LV wall thickness (WT) in patients with hypertrophic cardiomyopathy (HCM).

                                  Design and Setting Observational study at the National Cardiovascular Center and Nagoya University Hospital in Japan.

                                  Participants Thirty-six HCM patients and 16 patients with hypertensive LV hypertrophy (H-LVH).

                                  Main Outcome Measures Conventional echocardiography and strain rate (SR) imaging derived from tissue Doppler imaging were performed. Systolic strain (∊sys), peak systolic SR (SRsys), peak early diastolic SR (SRdia), and LVWT were obtained from eight LV segments. LV pressure was simultaneously recorded with a high-fidelity micromanometer.

                                  Results The regional ∊sys and SRsys were correlated with LVWT in HCM patients (r = 0.50, p < 0.0001 and r = 0.63, p < 0.0001, respectively) but not in H-LVH patients. The standard deviations of LVWT, ∊sys, and SRsys obtained from the eight LV segments of each subject were greater for HCM patients than for H-LVH patients. The standard deviation of LVWT was correlated with those of ∊sys and SRsys (r = 0.55, p < 0.001 and r = 0.56, p < 0.001, respectively). The standard deviations of LVWT, ∊sys, and SRsys were correlated with tau (r = 0.35, p < 0.05; r = 0.47, p < 0.0005; and r = 0.39, p < 0.005, respectively).

                                  Conclusions Heterogeneity of regional LV systolic function detected by SR imaging is in part attributable to heterogeneity of LV hypertrophy and may be linked to impaired global LV relaxation in HCM.

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