Left ventricular strain in hypertrophic cardiomyopathy assessed by three-dimensional speckle tracking echocardiography

Objective The aim of this study was to evaluate the capacity of three-dimensional speckle tracking echocardiographic(3DSTE)strain parameters in the assessment of left ventricular(LV)systolic function in patients with hypertrophic cardiomyopathy(HCM).Methods Thirty patients with HCM and 28healthy subjects were examined for 3DSTE analysis.The real-time 3Ddatasets were obtained and analyzed to derive the LV global and segmental longitudinal,radial and circumferential strains,as well as LV end systolic volume index(LVESVI)and end diastolic volume index(LVEDVI),LV mass index(LVMI)and LV ejection fraction(LVEF).The values of each 3DSTE indexes were compared between the HCM and healthy group,and 3DSTE global strain parameters were correlated with LV regional wall thickness in HCM.Draw receiver operating characteristic curves(ROC curves)on the LV global 3D,longitudinal,radial, circumferential strains and circumferential strain rate(LVG3DS)(LVGLS)(LVGRS)(LVGCS)(LVGCSR),and analysis of sensitivity and specificity.Results Compared with healthy group,HCM has lower LVESVI and LVESVI,but higher lLVMI(both P0.05).LV global strain and strain rate,most segmental strains and strain rates were significantly lower in HCM than in healthy group(P0.05);The LV global strain and strain rate showed a significant negative correlation with the LV wall thickness in most segments in HCM(P0.05).The area under receiver operating characteristics(AUC)curve of LVG3DS to diagnose HCM was 80.4%.The cutoff value,the sensitivity and Youden index of LVG3DS were 22.53,80.4% and 0.615.The cutoff value,the specificity and Youden index of LVGRS were 20.66,95.0% and 0.694.The cutoff value,the specificity and Youden index of LVGCSR were 1.055,95.0% and 0.694.Conclusion The decreased LV global and regional strains indicate the impaired LV systolic function in patients with HCM.LVG3DS is the most sensitive,LVGRS and LVGCSR are the most specific in all the strain parameters.3DSTE has the potential for accurate and sensitive assessment of myocardial mechanics,and providing a relatively simple approach to assess LV function precisely in future.