Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ - Brazil.
Instituto Nacional de Câncer, Rio de Janeiro, RJ - Brazil.
Arq Bras Cardiol. 2019 Sep 2;113(4):677-684. doi: 10.5935/abc.20190176. eCollection 2019.
Hypertrophic cardiomyopathy (HCM) is the most common heart disease of genetic origin in the world population, with a prevalence of at least 1/500. The association with systemic arterial hypertension (SAH) is not uncommon, as it affects approximately 25% of the world population. Most studies aim at the differential diagnosis between these diseases, but little is known about the magnitude of this association.
To compare left ventricular global longitudinal strain (GLS) in HCM patients with and without associated SAH.
Retrospective cross-sectional study that included 45 patients with HCM and preserved ejection fraction, with diagnosis confirmed by magnetic resonance imaging, including 14 hypertensive patients. Transthoracic echocardiography was performed, with emphasis on left ventricular myocardial strain analysis using GLS. In this study, p < 0.05 was considered statistically significant.
Left ventricular strain was significantly lower in hypertensive individuals compared to normotensive individuals (-10.29 ± 2.46 vs. -12.35% ± 3.55%, p = 0.0303), indicating greater impairment of ventricular function in that group. Mean age was also significantly higher in hypertensive patients (56.1 ± 13.9 vs. 40.2 ± 12.7 years, p = 0.0001). Diastolic dysfunction was better characterized in hypertensive patients (p = 0.0242).
Myocardial strain was significantly lower in the group of patients with HCM and SAH, suggesting greater impairment of ventricular function. This finding may be related to a worse prognosis with early evolution to heart failure. Prospective studies are required to confirm this hypothesis.
肥厚型心肌病（HCM）是世界人群中最常见的遗传性心脏病，患病率至少为 1/500。它与系统性动脉高血压（SAH）的关联并不罕见，因为它影响了大约 25%的世界人口。大多数研究旨在对这些疾病进行鉴别诊断，但对这种关联的程度知之甚少。
比较伴有和不伴有相关 SAH 的 HCM 患者的左心室整体纵向应变（GLS）。
回顾性横断面研究，纳入 45 例射血分数保留的 HCM 患者，诊断均经磁共振成像证实，其中包括 14 例高血压患者。进行经胸超声心动图检查，重点进行左心室心肌应变分析，使用 GLS。在这项研究中，p<0.05 被认为具有统计学意义。
与正常血压个体相比，高血压个体的左心室应变明显较低（-10.29±2.46%比-12.35%±3.55%，p=0.0303），表明该组心室功能受损更严重。高血压患者的平均年龄也明显较高（56.1±13.9 岁比 40.2±12.7 岁，p=0.0001）。高血压患者的舒张功能更差（p=0.0242）。
HCM 伴 SAH 患者的心肌应变明显较低，提示心室功能受损更严重。这一发现可能与预后较差有关，早期进展为心力衰竭。需要前瞻性研究来证实这一假设。
