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Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a primary myopathic process in which regional left ventricular dysfunction may exist without overt global left ventricular dysfunction. In obstructive HCM patients who underwent surgical myectomy (SM), we sought to determine if there is a significant...

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Autores principales: Dhillon, Ashwat, Sweet, Wendy, Popovic, Zoran B., Smedira, Nicholas G., Thamilarasan, Maran, Lytle, Bruce W., Tan, Carmela, Starling, Randall C., Lever, Harry M., Moravec, Christine S., Desai, Milind Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338715/
https://www.ncbi.nlm.nih.gov/pubmed/25389286
http://dx.doi.org/10.1161/JAHA.114.001269
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author Dhillon, Ashwat
Sweet, Wendy
Popovic, Zoran B.
Smedira, Nicholas G.
Thamilarasan, Maran
Lytle, Bruce W.
Tan, Carmela
Starling, Randall C.
Lever, Harry M.
Moravec, Christine S.
Desai, Milind Y.
author_facet Dhillon, Ashwat
Sweet, Wendy
Popovic, Zoran B.
Smedira, Nicholas G.
Thamilarasan, Maran
Lytle, Bruce W.
Tan, Carmela
Starling, Randall C.
Lever, Harry M.
Moravec, Christine S.
Desai, Milind Y.
author_sort Dhillon, Ashwat
collection PubMed
description BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a primary myopathic process in which regional left ventricular dysfunction may exist without overt global left ventricular dysfunction. In obstructive HCM patients who underwent surgical myectomy (SM), we sought to determine if there is a significant association between echocardiographic longitudinal strain, histopathology, and in vitro myocardial performance (resting tension and developed tension) of the surgical specimen. METHODS AND RESULTS: HCM patients (n=122, 54±14 years, 54% men) undergoing SM were prospectively recruited. Longitudinal systolic strain and diastolic strain rates were measured at that basal septum (partially removed at SM) by using velocity vector imaging on preoperative echocardiography. Semiquantitative histopathologic grading of myocyte disarray and fibrosis and in vitro measurements of resting tension and developed tension were made in septal tissue obtained at SM. Mean basal septal systolic strain and diastolic strain rate were −8.3±5% and 0.62±0.4/s, while mild or greater degree of myocyte disarray and interstitial fibrosis were present in 85% and 87%, respectively. Mean resting tension and developed tension were 2.8±1 and 1.4±0.8 g/mm(2). On regression analysis, basal septal systolic strain, diastolic strain rate, disarray, and fibrosis were associated with developed tension (β=0.19, 0.20, −0.33, and −0.40, respectively, all P<0.01) and resting tension (β=0.21, 0.22, −0.25, and −0.28, respectively, all P<0.01). CONCLUSION: In obstructive HCM patients who underwent SM, left ventricular mechanics (echocardiographic longitudinal systolic strain and diastolic strain rates), assessed at the basal septum (myocardium removed during myectomy) and histopathologic findings characteristic for HCM (disarray and fibrosis) were significantly associated with in vitro myocardial resting and developed contractile performance.
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spelling pubmed-43387152015-02-27 Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients Dhillon, Ashwat Sweet, Wendy Popovic, Zoran B. Smedira, Nicholas G. Thamilarasan, Maran Lytle, Bruce W. Tan, Carmela Starling, Randall C. Lever, Harry M. Moravec, Christine S. Desai, Milind Y. J Am Heart Assoc Original Research BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a primary myopathic process in which regional left ventricular dysfunction may exist without overt global left ventricular dysfunction. In obstructive HCM patients who underwent surgical myectomy (SM), we sought to determine if there is a significant association between echocardiographic longitudinal strain, histopathology, and in vitro myocardial performance (resting tension and developed tension) of the surgical specimen. METHODS AND RESULTS: HCM patients (n=122, 54±14 years, 54% men) undergoing SM were prospectively recruited. Longitudinal systolic strain and diastolic strain rates were measured at that basal septum (partially removed at SM) by using velocity vector imaging on preoperative echocardiography. Semiquantitative histopathologic grading of myocyte disarray and fibrosis and in vitro measurements of resting tension and developed tension were made in septal tissue obtained at SM. Mean basal septal systolic strain and diastolic strain rate were −8.3±5% and 0.62±0.4/s, while mild or greater degree of myocyte disarray and interstitial fibrosis were present in 85% and 87%, respectively. Mean resting tension and developed tension were 2.8±1 and 1.4±0.8 g/mm(2). On regression analysis, basal septal systolic strain, diastolic strain rate, disarray, and fibrosis were associated with developed tension (β=0.19, 0.20, −0.33, and −0.40, respectively, all P<0.01) and resting tension (β=0.21, 0.22, −0.25, and −0.28, respectively, all P<0.01). CONCLUSION: In obstructive HCM patients who underwent SM, left ventricular mechanics (echocardiographic longitudinal systolic strain and diastolic strain rates), assessed at the basal septum (myocardium removed during myectomy) and histopathologic findings characteristic for HCM (disarray and fibrosis) were significantly associated with in vitro myocardial resting and developed contractile performance. Blackwell Publishing Ltd 2014-11-11 /pmc/articles/PMC4338715/ /pubmed/25389286 http://dx.doi.org/10.1161/JAHA.114.001269 Text en © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/3.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Dhillon, Ashwat
Sweet, Wendy
Popovic, Zoran B.
Smedira, Nicholas G.
Thamilarasan, Maran
Lytle, Bruce W.
Tan, Carmela
Starling, Randall C.
Lever, Harry M.
Moravec, Christine S.
Desai, Milind Y.
Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title_full Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title_fullStr Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title_full_unstemmed Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title_short Association of Noninvasively Measured Left Ventricular Mechanics With In Vitro Muscle Contractile Performance: A Prospective Study in Hypertrophic Cardiomyopathy Patients
title_sort association of noninvasively measured left ventricular mechanics with in vitro muscle contractile performance: a prospective study in hypertrophic cardiomyopathy patients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338715/
https://www.ncbi.nlm.nih.gov/pubmed/25389286
http://dx.doi.org/10.1161/JAHA.114.001269
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