Can Myocardial Strain Differentiate Hypertrophic from Infiltrative Etiology of a Thickened Septum?

Objectives: Radial systolic strain (ɛ) assessed by echocardiography has been shown to identify patterns of normal septal motion brought about by different layers, including left ventricular (LV) subendocardial (LV subendo) and mural (LV mural) layers. We aimed to use myocardial strain in assessing r...

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Publicado en:Echocardiography Vol. 28; no. 4; pp. 408 - 416
Autores principales: Engvall, Christer, Henein, Michael, Holmgren, Anders, Suhr, Ole B., Mörner, Stellan, Lindqvist, Per
Formato: diagnostic images research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Apr2011
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Can Myocardial Strain Differentiate Hypertrophic from Infiltrative Etiology of a Thickened Septum?
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        au:
          Engvall, Christer
          Henein, Michael
          Holmgren, Anders
          Suhr, Ole B.
          Mörner, Stellan
          Lindqvist, Per
        affil: Department of Clinical Physiology
      sug:
        subj:
          Heart Septum Pathology
          Heart Septum Ultrasonography
          Myocardial Diseases Etiology
          Myocardial Diseases Ultrasonography
          Echocardiography Methods
          Human
          Descriptive Statistics
          Middle Age
          Aged
          Male
          Female
          Academic Medical Centers
          Sweden
          Data Analysis Software
          Unpaired T-Tests
          One-Way Analysis of Variance
          Paired T-Tests
          Heart Ventricle, Left Physiopathology
          Heart Ventricle, Left Ultrasonography
          Funding Source
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Objectives: Radial systolic strain (ɛ) assessed by echocardiography has been shown to identify patterns of normal septal motion brought about by different layers, including left ventricular (LV) subendocardial (LV subendo) and mural (LV mural) layers. We aimed to use myocardial strain in assessing radial and longitudinal myocardial function in normal and thickened septum and to test if myocardial strain can differentiate hypertrophic from infiltrative cause of thickened septum. Methods: Forty-five patients (age 61 ± 13 years, 22 males), 13 with hypertrophic cardiomyopathy, 15 with aortic stenosis, and 17 with familial amyloid polyneuropathy, were studied and compared with 29 controls (age 61 ± 12 years, 17 males) using 1D strain and conventional echocardiography. Results: Patients had normal LV ejection fraction and stroke volume but heart rate was higher (P < 0.05) compared to controls. Septal ɛ was reduced (-7.6 ± 7.0% vs. -14.0 ± 5.5%, for LV mural and -7.9 ± 14.7% vs. -20.3 ±-7.9% for LV subendo, P < 0.001 for both layers) across LV longitudinal axis but not along its radial axis. No difference was found in any of ɛ measurements between patient groups. A decrease in strain length by 50% increased the septal strain by more than 60% in both radial and longitudinal axes. Conclusion: Septal systolic strain measurements showed reduced longitudinal function but its localized nature failed to demonstrate radial disturbances in patients with pathologically thickened septum. No difference was found in systolic strain between patients according to the etiology of septal thickness. This limitation might be either technical or is explained by the maintained radial function in all patient groups. (Echocardiography 2011;28:408-415)
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        tracings
        Journal Article
      ougenre: Article
    language: English
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