О.М. Trembovetska, G.V. Knyshov, V.P. Zakharova.Longitudinal segmental displacement of left ventricular walls in patients with hypertrophic cardiomyopathy

The aim – to study the features of longitudinal segmental displacement of left ventricular (LV) walls in patients with multiple types of hypertrophic cardiomyopathy.

Material and methods. 93 patients with hypertrophic cardiomyopathy and 35 patients without cardiac pathology have been involved into study. Common laboratory methods of examination and complex echocardiography, including Speckle-tracking echocardiography, have been carried out. Patients with hypertrophic cardiomyopathy have been assigned to 4 groups, according to the NYHA functional class and systolic gradient of the LV outflow tract.

Results. The study revealed that obstruction of the LV outflow tract is related to the signs of heart failure in patients with hypertrophic cardiomyopathy. Amplitude of the longitudinal displacement of the LV myocardium in normal condition and in hypertrophic cardiomyopathy in all walls was always the largest at the level of basal segments and achieved minimal level at the apex.

Conclusions. In hypertrophic cardiomyopathy the vector of longitudinal systolic displacement of LV walls is similar to normal ones. During the normal heartbeat and hypertrophic cardiomyopathy the peak values of longitudinal displacement were demonstrated by the basal segments of the LV, whereas the apex of the heart remained almost static. There is a direct relation between the value of systolic gradient in the LV outflow tract and number of segments with diminished function of longitudinal displacement, as well as the grade of circulatory deficiency. The indices of longitudinal displacement are lowering first in basal segments of anterior and septal regions. As the obstruction of the LV outflow tract increases, the rest segments are being involved into pathological process.

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