О.М. Trembovetska.Study of the rotational motion of left ventricular walls in patients with hypertrophic cardiomyopathy using speckle tracking echocardiography

The aim – to study rotational motion of left ventricular walls in patients with various forms of hypertrophic cardiomyopathy.
Material and methods. Ninety three patients with hypertrophic cardiomyopathy and 35 patients without cardiac pathology have been included into the study. Common clinical methods of examination and complex echocardiography, including speckle tracking echocardiography, have been carried out. Patients with hypertrophic cardiomyopathy were assigned to 4 groups, depending on NYHA functional class and left ventricular outflow tract systolic pressure gradient.
Results. The direction of rotational motion of basal and apical parts of the left ventricle in hypertrophic cardiomyopathy is not changed. The least changes in twist occur in case of systolic gradient in left ventricular outflow tract elevation up to 13.7±5.4 mm Hg (Group І). Increase of systolic pressure gradient in left ventricular outflow tract up to 97.9±18.1 mm Hg is accompanied by compensatory rise of myocardium twist up to 25.2±5.3 ° (Group ІІ). In group of hypertrophic cardiomyopathy (Group IIІ) significant lowering of twist angle up to 9.5±2.6 ° in case of rather high systolic pressure gradient 69.3±22.9 mm Hg is detected along with development of heart failure. The lowest (9.0±2.9 °) degree of myocardium twist is observed in patients with congestive heart failure (Group IV); at the same time lowering of systolic pressure gradient in left ventricular outflow tract up to 10.7±4.7 mm Hg is detected.
Conclusions. In hypertrophic cardiomyopathy the rotational capacity of left ventricular myocardium depends on the stage of heart failure and is associated with changes of the systolic pressure gradient in left ventricular outflow tract.

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