Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine, Toon, Japan.
Circ J. 2013;77(4):1040-5. doi: 10.1253/circj.cj-12-0752. Epub 2012 Dec 19.
The interventricular septum in hypertrophic cardiomyopathy (HC) has a unique shape, which is characterized by the convex curvature toward the left ventricle (LV). The aim of this study was to examine the relationship between curvature of the LV wall and regional myocardial strain.
Fifty-six patients with HC (mean age, 55±12 years) and 20 age- and sex-matched control subjects (mean age, 56±8 years) were enrolled. The curvature index (1/radius) was measured by drawing along the endocardial surface from the apical 4-chamber and short axis views. Peak systolic strain was calculated in the septal and lateral walls using 2-D speckle tracking echocardiography. The septal curvature index and septal longitudinal strain were significantly lower in the HC group than in the control group. A multivariate model using the HC patient data showed that the septal curvature index and septal thickness were the independent determinants of septal longitudinal strain (septal curvature index: β=-0.421, P<0.001; septal thickness: β=0.401, P=0.002). In addition, global longitudinal strain and E/e' were worse in the lower septal curvature index group compared with the higher group.
Septal longitudinal strain is associated with the degree of septal curvature. This indicates a possible link between LV wall configuration and regional myocardial function.
肥厚型心肌病（HC）的室间隔具有独特的形状，其特征是向左侧心室（LV）凸曲。本研究旨在探讨 LV 壁曲率与局部心肌应变之间的关系。
纳入 56 例 HC 患者（平均年龄 55±12 岁）和 20 例年龄和性别匹配的对照组患者（平均年龄 56±8 岁）。通过从心尖 4 腔和短轴视图的内膜表面绘制来测量曲率指数（1/radius）。使用 2-D 斑点追踪超声心动图计算间隔壁和侧壁的收缩期峰值应变。HC 组的间隔曲率指数和间隔纵向应变明显低于对照组。使用 HC 患者数据的多变量模型显示，间隔曲率指数和间隔厚度是间隔纵向应变的独立决定因素（间隔曲率指数：β=-0.421，P<0.001；间隔厚度：β=0.401，P=0.002）。此外，较低间隔曲率指数组的整体纵向应变和 E/e'较较高组差。
间隔纵向应变与间隔曲率的程度相关。这表明 LV 壁构型与局部心肌功能之间可能存在联系。
