Skip to main content
Erschienen in: The International Journal of Cardiovascular Imaging 7/2018

27.02.2018 | Original Paper

Characterization of hypertrophic cardiomyopathy according to global, regional, and multi-layer longitudinal strain analysis, and prediction of sudden cardiac death

verfasst von: Marie-Philippe Vergé, Hubert Cochet, Amélie Reynaud, Lucas Morlon, Jérôme Peyrou, Cécile Vincent, Caroline Rooryck, Philippe Ritter, Stéphane Lafitte, Patricia Réant

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 7/2018

Einloggen, um Zugang zu erhalten

Abstract

To evaluate the severity of hypertrophic cardiomyopathy (HCM) according to global, regional, and multi-layer longitudinal strain (LS) analysis using speckle-tracking echocardiography. From February 2007 to November 2014, we prospectively evaluated 375 consecutive HCM patients referred to our specialized cardiomyopathy center. Demographics, clinical, and rest and exercise echocardiographic parameters were collected according to a completely standardized protocol. Global, regional, and multilayer strain analyses were performed. Correlations between LS and other characteristics were evaluated, and we assessed their prognostic value to predict sudden cardiac death (SCD) or appropriate implantable cardioverter defibrillator (ICD) shocks during follow-up, using Cox proportional hazards analyses. We finally included 217 patients (50.1 ± 15.6 years, 67% male) but only 179 (82%) had LS analysis of sufficient quality. An inverse relation was observed between the mean basal left ventricular (LV) LS and diastolic parameters [E/Ea (r = − 0.30) and left atrium indexed volume (r = − 0.23)], as well as between the resting LV outflow-tract maximal gradient (r = − 0.26) or during peak exercise (r = − 0.20). Mean LS in the LV hypertrophic area was particularly related with maximal wall thickness (r = − 0.47) and transmural global LS with the degree of myocardial fibrosis in cardiac magnetic resonance (r = − 0.32). During a median follow-up of 2.8 ± 1.5 years, mean transmural LS in the hypertrophic area was predictor of SCD and appropriate ICD shock (10 events/179 patients, hazard ratio = 0.83 [95% CI 0.72–0.95], p = 0.01). Basal LS and hypertrophic area LS are valuable parameters to evaluate HCM severity. Mean hypertrophic area LS particularly seems predictive of SCD occurrence and appropriate ICD shocks.
Literatur
1.
Zurück zum Zitat Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99CrossRefPubMed Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99CrossRefPubMed
2.
Zurück zum Zitat Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779CrossRefPubMed Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779CrossRefPubMed
3.
Zurück zum Zitat Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:e783–e831CrossRefPubMed Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW (2011) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:e783–e831CrossRefPubMed
4.
Zurück zum Zitat Maron MS, Pandian NG (2010) Risk stratification in hypertrophic cardiomyopathy: is two-dimensional echocardiographic strain ready for prime time? J Am Soc Echocardiogr 23:591–594CrossRefPubMed Maron MS, Pandian NG (2010) Risk stratification in hypertrophic cardiomyopathy: is two-dimensional echocardiographic strain ready for prime time? J Am Soc Echocardiogr 23:591–594CrossRefPubMed
5.
Zurück zum Zitat Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R, Lafitte S (2006) Global and regional myocardial function quantification by two-dimensional strain: application in hypertrophic cardiomyopathy. J Am Coll Cardiol 47:1175–1181CrossRefPubMed Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R, Lafitte S (2006) Global and regional myocardial function quantification by two-dimensional strain: application in hypertrophic cardiomyopathy. J Am Coll Cardiol 47:1175–1181CrossRefPubMed
6.
Zurück zum Zitat Saito M, Okayama H, Yoshii T, Higashi H, Morioka H, Hiasa G, Sumimoto T, Inaba S, Nishimura K, Inoue K, Ogimoto A, Shigematsu Y, Hamada M, Higaki J (2012) Clinical significance of global two-dimensional strain as a surrogate parameter of myocardial fibrosis and cardiac events in patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 13:617–623CrossRefPubMed Saito M, Okayama H, Yoshii T, Higashi H, Morioka H, Hiasa G, Sumimoto T, Inaba S, Nishimura K, Inoue K, Ogimoto A, Shigematsu Y, Hamada M, Higaki J (2012) Clinical significance of global two-dimensional strain as a surrogate parameter of myocardial fibrosis and cardiac events in patients with hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 13:617–623CrossRefPubMed
7.
Zurück zum Zitat Hiemstra YL, Debonnaire P, Bootsma M, Van Zwet EW, Delgado V, Schalij MJ, Atsma DE, Bax JJ, Marsan NA (2017) Global longitudinal strain and left atrial volume index provide incremental prognostic value in patients with hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 10:e005706CrossRefPubMed Hiemstra YL, Debonnaire P, Bootsma M, Van Zwet EW, Delgado V, Schalij MJ, Atsma DE, Bax JJ, Marsan NA (2017) Global longitudinal strain and left atrial volume index provide incremental prognostic value in patients with hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 10:e005706CrossRefPubMed
8.
Zurück zum Zitat Reant P, Reynaud A, Pillois X, Dijos M, Arsac F, Touche C, Landelle M, Rooryck C, Roudaut R, Lafitte S (2015) Comparison of resting and exercise echocardiographic parameters as indicators of outcomes in hypertrophic cardiomyopathy. J Am Soc Echocardiogr 28:194–203CrossRefPubMed Reant P, Reynaud A, Pillois X, Dijos M, Arsac F, Touche C, Landelle M, Rooryck C, Roudaut R, Lafitte S (2015) Comparison of resting and exercise echocardiographic parameters as indicators of outcomes in hypertrophic cardiomyopathy. J Am Soc Echocardiogr 28:194–203CrossRefPubMed
9.
Zurück zum Zitat Ozawa K, Funabashi N, Takaoka H, Kamata T, Kanaeda A, Saito M, Nomura F, Kobayashi Y (2015) Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique. Int J Cardiol 184C:237–243CrossRef Ozawa K, Funabashi N, Takaoka H, Kamata T, Kanaeda A, Saito M, Nomura F, Kobayashi Y (2015) Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique. Int J Cardiol 184C:237–243CrossRef
10.
Zurück zum Zitat Ozawa K, Funabashi N, Kamata T, Kobayashi Y (2017) Inter- and intraobserver consistency in LV myocardial strain measurement using a novel multi-layer technique in patients with severe aortic stenosis and preserved LV ejection fraction. Int J Cardiol 228:687–693CrossRefPubMed Ozawa K, Funabashi N, Kamata T, Kobayashi Y (2017) Inter- and intraobserver consistency in LV myocardial strain measurement using a novel multi-layer technique in patients with severe aortic stenosis and preserved LV ejection fraction. Int J Cardiol 228:687–693CrossRefPubMed
11.
Zurück zum Zitat Sebastian SI, Haugaa KH, Zahid W, Bendz B, Aakhus S, Aaberge L, Edvardsen T (2013) Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non–ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging 6:535–544CrossRef Sebastian SI, Haugaa KH, Zahid W, Bendz B, Aakhus S, Aaberge L, Edvardsen T (2013) Layer-specific quantification of myocardial deformation by strain echocardiography may reveal significant CAD in patients with non–ST-segment elevation acute coronary syndrome. JACC Cardiovasc Imaging 6:535–544CrossRef
12.
Zurück zum Zitat Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMed Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, Flachskampf FA, Foster E, Goldstein SA, Kuznetsova T, Lancellotti P, Muraru D, Picard MH, Rietzschel ER, Rudski L, Spencer KT, Tsang W, Voigt JU (2015) Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 16:233–270CrossRefPubMed
13.
Zurück zum Zitat Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL (2008) European Association of Echocardiography. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr 9:415–437CrossRefPubMed Sicari R, Nihoyannopoulos P, Evangelista A, Kasprzak J, Lancellotti P, Poldermans D, Voigt JU, Zamorano JL (2008) European Association of Echocardiography. Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr 9:415–437CrossRefPubMed
14.
Zurück zum Zitat Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713CrossRefPubMed Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, Solomon SD, Louie EK, Schiller NB (2010) Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr 23:685–713CrossRefPubMed
15.
Zurück zum Zitat Maron MS, Olivotto I, Betocchi S, Casey SA, Lesser JR, Losi MA, Cecchi F, Maron BJ (2003) Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med 348:295–303CrossRefPubMed Maron MS, Olivotto I, Betocchi S, Casey SA, Lesser JR, Losi MA, Cecchi F, Maron BJ (2003) Effect of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy. N Engl J Med 348:295–303CrossRefPubMed
16.
Zurück zum Zitat Leitman M, Lysyansky P, Sidenko S, Shir V, Peleg E, Binenbaum M, Kaluski E, Krakover R, Vered Z (2004) Two-dimensional strain-a novel software for realtime quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 17:1021–1029CrossRefPubMed Leitman M, Lysyansky P, Sidenko S, Shir V, Peleg E, Binenbaum M, Kaluski E, Krakover R, Vered Z (2004) Two-dimensional strain-a novel software for realtime quantitative echocardiographic assessment of myocardial function. J Am Soc Echocardiogr 17:1021–1029CrossRefPubMed
17.
Zurück zum Zitat Chan RH, Maron BJ, Olivotto I, Pencina MJ, Assenza GE, Haas T, Lesser JR, Gruner C, Crean AM, Rakowski H, Udelson JE, Rowin E, Lombardi M, Cecchi F, Tomberli B, Spirito P, Formisano F, Biagini E, Rapezzi C, De Cecco CN, Autore C, Cook EF, Hong SN, Gibson CM, Manning WJ, Appelbaum E, Maron MS (2014) Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation 130:484–495CrossRefPubMed Chan RH, Maron BJ, Olivotto I, Pencina MJ, Assenza GE, Haas T, Lesser JR, Gruner C, Crean AM, Rakowski H, Udelson JE, Rowin E, Lombardi M, Cecchi F, Tomberli B, Spirito P, Formisano F, Biagini E, Rapezzi C, De Cecco CN, Autore C, Cook EF, Hong SN, Gibson CM, Manning WJ, Appelbaum E, Maron MS (2014) Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation 130:484–495CrossRefPubMed
18.
Zurück zum Zitat Peyrou J, Réant P, Reynaud A, Cornolle C, Dijos M, Rooryck-Thambo C, Landelle M, Montaudon M, Laurent F, Roudaut R, Lafitte S (2016) Morphological and functional abnormalities pattern in hypertrophy-free HCM mutation carriers detected with echocardiography. Int J Cardiovasc Imaging 32:1379–1389CrossRefPubMed Peyrou J, Réant P, Reynaud A, Cornolle C, Dijos M, Rooryck-Thambo C, Landelle M, Montaudon M, Laurent F, Roudaut R, Lafitte S (2016) Morphological and functional abnormalities pattern in hypertrophy-free HCM mutation carriers detected with echocardiography. Int J Cardiovasc Imaging 32:1379–1389CrossRefPubMed
19.
Zurück zum Zitat Reant P, Mirabel M, Lloyd G, Peyrou J, Lopez Ayala JM, Dickie S, Bulluck H, Captur G, Rosmini S, Guttmann O, Demetrescu C, Pantazis A, Tome-Esteban M, Moon JC, Lafitte S, McKenna WJ (2016) Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy. Heart 102:741–747CrossRefPubMed Reant P, Mirabel M, Lloyd G, Peyrou J, Lopez Ayala JM, Dickie S, Bulluck H, Captur G, Rosmini S, Guttmann O, Demetrescu C, Pantazis A, Tome-Esteban M, Moon JC, Lafitte S, McKenna WJ (2016) Global longitudinal strain is associated with heart failure outcomes in hypertrophic cardiomyopathy. Heart 102:741–747CrossRefPubMed
20.
Zurück zum Zitat Debonnaire P, Thijssen J, Leong DP, Joyce E, Katsanos S, Hoogslag GE, Schalij MJ, Atsma DE, Bax JJ, Delgado V, Marsan NA (2014) Global longitudinal strain and left atrial volume index improve prediction of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy patients. Int J Cardiovasc Imaging 30:549–558CrossRefPubMed Debonnaire P, Thijssen J, Leong DP, Joyce E, Katsanos S, Hoogslag GE, Schalij MJ, Atsma DE, Bax JJ, Delgado V, Marsan NA (2014) Global longitudinal strain and left atrial volume index improve prediction of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy patients. Int J Cardiovasc Imaging 30:549–558CrossRefPubMed
21.
Zurück zum Zitat Haland TF, Almaas VM, Hasselberg NE, Saberniak J, Leren IS, Hopp E, Edvardsen T, Haugaa KH (2016) Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 17:613–621CrossRefPubMedPubMedCentral Haland TF, Almaas VM, Hasselberg NE, Saberniak J, Leren IS, Hopp E, Edvardsen T, Haugaa KH (2016) Strain echocardiography is related to fibrosis and ventricular arrhythmias in hypertrophic cardiomyopathy. Eur Heart J Cardiovasc Imaging 17:613–621CrossRefPubMedPubMedCentral
22.
Zurück zum Zitat Candan O, Gecmen C, Bayam E, Guner A, Celik M, Doğan C (2017) Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy. Echocardiography 34:835–842CrossRefPubMed Candan O, Gecmen C, Bayam E, Guner A, Celik M, Doğan C (2017) Mechanical dispersion and global longitudinal strain by speckle tracking echocardiography: predictors of appropriate implantable cardioverter defibrillator therapy in hypertrophic cardiomyopathy. Echocardiography 34:835–842CrossRefPubMed
23.
Zurück zum Zitat Schiano-Lomoriello V, Galderisi M, Mele D, Esposito R, Cerciello G, Buonauro A, Della Pepa R, Picardi M, Catalano L, Trimarco B, Pane F (2016) Longitudinal strain of left ventricular basal segments and E/e′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study. Echocardiography 33:1335–1343CrossRefPubMed Schiano-Lomoriello V, Galderisi M, Mele D, Esposito R, Cerciello G, Buonauro A, Della Pepa R, Picardi M, Catalano L, Trimarco B, Pane F (2016) Longitudinal strain of left ventricular basal segments and E/e′ ratio differentiate primary cardiac amyloidosis at presentation from hypertensive hypertrophy: an automated function imaging study. Echocardiography 33:1335–1343CrossRefPubMed
24.
Zurück zum Zitat Di Salvo G, Pacileo G, Limongelli G, Baldini L, Rea A, Verrengia M, D’Andrea A, Russo MG, Calabrò R (2010) Non sustained ventricular tachycardia in hypertrophic cardiomyopathy and new ultrasonic derived parameters. J Am Soc Echocardiogr 23:581–590CrossRefPubMed Di Salvo G, Pacileo G, Limongelli G, Baldini L, Rea A, Verrengia M, D’Andrea A, Russo MG, Calabrò R (2010) Non sustained ventricular tachycardia in hypertrophic cardiomyopathy and new ultrasonic derived parameters. J Am Soc Echocardiogr 23:581–590CrossRefPubMed
25.
Zurück zum Zitat Zhang L, Zhou X, Wang J, Mu Y, Liu B, Lv W, Wang Y, Liu H, Liu H, Zhi G (2017) Differentiation of light-chain cardiac amyloidosis from hypertrophic cardiomyopathy using myocardial mechanical parameters by velocity vector imaging echocardiography. Int J Cardiovasc Imaging 33:499–507CrossRefPubMed Zhang L, Zhou X, Wang J, Mu Y, Liu B, Lv W, Wang Y, Liu H, Liu H, Zhi G (2017) Differentiation of light-chain cardiac amyloidosis from hypertrophic cardiomyopathy using myocardial mechanical parameters by velocity vector imaging echocardiography. Int J Cardiovasc Imaging 33:499–507CrossRefPubMed
Metadaten
Titel
Characterization of hypertrophic cardiomyopathy according to global, regional, and multi-layer longitudinal strain analysis, and prediction of sudden cardiac death
verfasst von
Marie-Philippe Vergé
Hubert Cochet
Amélie Reynaud
Lucas Morlon
Jérôme Peyrou
Cécile Vincent
Caroline Rooryck
Philippe Ritter
Stéphane Lafitte
Patricia Réant
Publikationsdatum
27.02.2018
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 7/2018
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-018-1323-3

Weitere Artikel der Ausgabe 7/2018

The International Journal of Cardiovascular Imaging 7/2018 Zur Ausgabe

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.