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Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy

BACKGROUND: The effects of focal hypertrophy on geometry of the left ventricle and systolic function have not been studied in patients with hypertrophic cardiomyopathy (HCM), despite the fact that the former is the most prominent disease characteristic. The aim of our study was to analyze systolic f...

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Autores principales: Boban, Marko, Pesa, Vladimir, Kauzlaric, Helena Antic, Brusich, Sandro, Rotim, Ante, Madzar, Tomislav, Zulj, Marinko, Vcev, Aleksandar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892461/
https://www.ncbi.nlm.nih.gov/pubmed/29602944
http://dx.doi.org/10.12659/MSM.906111
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author Boban, Marko
Pesa, Vladimir
Kauzlaric, Helena Antic
Brusich, Sandro
Rotim, Ante
Madzar, Tomislav
Zulj, Marinko
Vcev, Aleksandar
author_facet Boban, Marko
Pesa, Vladimir
Kauzlaric, Helena Antic
Brusich, Sandro
Rotim, Ante
Madzar, Tomislav
Zulj, Marinko
Vcev, Aleksandar
author_sort Boban, Marko
collection PubMed
description BACKGROUND: The effects of focal hypertrophy on geometry of the left ventricle and systolic function have not been studied in patients with hypertrophic cardiomyopathy (HCM), despite the fact that the former is the most prominent disease characteristic. The aim of our study was to analyze systolic function over ventricle geometry, generating a functional index made from left ventricle end diastolic dimension (LVEDD) divided by end diastolic thickness of the region with maximal extent of hypertrophy and interventricular septum. MATERIAL/METHODS: Our hospital database of cardiac magnetic resonance was screened for HCM. Geometric functional index (GFI) was calculated for LVEDD over maximal end diastolic thickness (MaxEDT) giving GFI-M, while LVEDD over interventricular septum was expressed as GFI-I. There were 55 consecutive patients with HCM. RESULTS: There were 43 males (78.2%) and 12 females (21.8%). The mean age was 52.3±16.7 years (range: 15.5–76.4 years). A significant difference of GFI was found for preserved versus impaired systolic function of the left ventricle (preserved systolic function); GFI-M 2.28±0.60 versus 3.66±0.50 (p<0.001), and GFI-I 2.75±0.88 versus 3.81±0.87 (p<0.001), respectively. Diagnostic value was tested using receiver operating curve (ROC) analyzes, with GFI-M area under curve (AUC)=0.959 (95% CI: 0.868–0.994); (p<0.001) and GFI-I-AUC=0.847 (0.724–0.930); (p<0.001). GFI-M was superior to GFI-I for appraisal of left ventricle systolic dysfunction in HCM; ΔAUC=0.112 (0.018–0.207); (p=0.020). CONCLUSIONS: GFI is a simple tool, with high sensitivity and specificity for detecting impairment of systolic function in patients with HCM. Further studies would be necessary to investigate its clinical and prognostic impacts, as well as reproducibility with prospective validation.
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spelling pubmed-58924612018-04-18 Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy Boban, Marko Pesa, Vladimir Kauzlaric, Helena Antic Brusich, Sandro Rotim, Ante Madzar, Tomislav Zulj, Marinko Vcev, Aleksandar Med Sci Monit Clinical Research BACKGROUND: The effects of focal hypertrophy on geometry of the left ventricle and systolic function have not been studied in patients with hypertrophic cardiomyopathy (HCM), despite the fact that the former is the most prominent disease characteristic. The aim of our study was to analyze systolic function over ventricle geometry, generating a functional index made from left ventricle end diastolic dimension (LVEDD) divided by end diastolic thickness of the region with maximal extent of hypertrophy and interventricular septum. MATERIAL/METHODS: Our hospital database of cardiac magnetic resonance was screened for HCM. Geometric functional index (GFI) was calculated for LVEDD over maximal end diastolic thickness (MaxEDT) giving GFI-M, while LVEDD over interventricular septum was expressed as GFI-I. There were 55 consecutive patients with HCM. RESULTS: There were 43 males (78.2%) and 12 females (21.8%). The mean age was 52.3±16.7 years (range: 15.5–76.4 years). A significant difference of GFI was found for preserved versus impaired systolic function of the left ventricle (preserved systolic function); GFI-M 2.28±0.60 versus 3.66±0.50 (p<0.001), and GFI-I 2.75±0.88 versus 3.81±0.87 (p<0.001), respectively. Diagnostic value was tested using receiver operating curve (ROC) analyzes, with GFI-M area under curve (AUC)=0.959 (95% CI: 0.868–0.994); (p<0.001) and GFI-I-AUC=0.847 (0.724–0.930); (p<0.001). GFI-M was superior to GFI-I for appraisal of left ventricle systolic dysfunction in HCM; ΔAUC=0.112 (0.018–0.207); (p=0.020). CONCLUSIONS: GFI is a simple tool, with high sensitivity and specificity for detecting impairment of systolic function in patients with HCM. Further studies would be necessary to investigate its clinical and prognostic impacts, as well as reproducibility with prospective validation. International Scientific Literature, Inc. 2018-03-31 /pmc/articles/PMC5892461/ /pubmed/29602944 http://dx.doi.org/10.12659/MSM.906111 Text en © Med Sci Monit, 2018 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Clinical Research
Boban, Marko
Pesa, Vladimir
Kauzlaric, Helena Antic
Brusich, Sandro
Rotim, Ante
Madzar, Tomislav
Zulj, Marinko
Vcev, Aleksandar
Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title_full Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title_fullStr Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title_full_unstemmed Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title_short Ventricular Diastolic Dimension over Maximal Myocardial Thickness is Robust Landmark of Systolic Impairment in Patients with Hypertrophic Cardiomyopathy
title_sort ventricular diastolic dimension over maximal myocardial thickness is robust landmark of systolic impairment in patients with hypertrophic cardiomyopathy
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5892461/
https://www.ncbi.nlm.nih.gov/pubmed/29602944
http://dx.doi.org/10.12659/MSM.906111
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