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Objectives: The impairment of right ventricular (RV) myocardial mechanics is evident in hypertrophic cardiomyopathy (HCM). It is independently influenced by LV mechanics and correlated to the severity of LV phenotype. We investigated the changes in RV global and regional deformation following surgical septal myectomy using vector velocity imaging (VVI). Methods: 25 HCM patients, 68% males with mean age (34.5 ± 12 years) were examined before and within two months after surgical myectomy using VVI. In addition to conventional echocardiographic parameters, peak systolic strain (εsys), strain rate (SR) and time to peak εsys (TTP) of regional RV free wall (RVFW) & septal walls were analyzed in longitudinal (long) directions from apical four-chamber view and their (Δ) changes were calculated. Similar parameters were quantified in LV from apical 2 & 4 CH views. Intra-V-delay was defined as SD of TTP and inter-V dyssynchrony was estimated from TTP difference between the most delayed LV segment & RVFW. Results: All study patients showed improvement of their functional class from NYHA class III to class I and reduction of LVOT gradient to below 20 mmHg except one patient who had 30 mmHg gradients at rest. There was significant reduction of septal thickness, left atrial diameter & volume, LVOT gradient, LVMI, severity of mitral regurgitation, tricuspid annular velocities (P < 0.0001), RV diameter (P < 0.02) and increase in LV internal dimensions(P < 0.001) post myectomy. However, there was significant reduction of RV and LV systolic mechanics;RV global εsys % (from -16.1% ± 4.4% to -12.9% ± 2.9%, P < 0.0001) and LV global εsys %: from -11.6% ± 2.8% to -9.4% ± 2.2%, P < 0.0001) respectively. The magnitude of reduction of RV strain (ΔRV εsys %, ΔSRsys) was directly correlated LV maximal wall thickness (r = 0.46, P < 0.01) and ΔRV dyssynchrony (TTP-SD) (r = 0.4, P < 0.05) and negatively correlated to age (r = -0.46, P sys (r = -0.52, P < 0.01) and pre-op LV EF % (r = -0.43, P , the reduction in RV diastolic mecha
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篇名 Right Ventricular Mechanical Changes after Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy: Vector Velocity Imaging Study
来源期刊 心血管病(英文) 学科 医学
关键词 RIGHT VENTRICLE Deformation Imaging HYPERTROPHIC CARDIOMYOPATHY
年,卷(期) xxgbyw_2019,(7) 所属期刊栏目
研究方向 页码范围 467-488
页数 22页 分类号 R73
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RIGHT
VENTRICLE
Deformation
Imaging
HYPERTROPHIC
CARDIOMYOPATHY
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研究分支
研究去脉
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期刊影响力
心血管病(英文)
月刊
2164-5329
武汉市江夏区汤逊湖北路38号光谷总部空间
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224
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