Assessment of regional myocardial function in patients with hypertrophic cardiomyopathy by tissue strain imaging.

The value of tissue strain imaging (SI) in regional myocardial systolic and diastolic function assessment was studied. In 18 patients with nonobstructive hypertrophic cardiomyopathy (HCM) and 20 age-matched healthy subjects, regional myocardial longitudinal peak systolic strain in eject time (represented by epsilon(et)) was measured at basal, mid and apical segments of septal, lateral and posterior walls of the left ventricle (LV) and compared between groups. Epsilon(et) had no significant difference between segments in control group (P > 0.05), which displayed a decreasing trend from basal segments to apical ones. Epsilon(et) in the HCM group was significantly decreased (P < 0.05) as compared with that in the healthy group. In the HCM group, epsilon(et) in the midseptum was significantly less than at the basal and apical septum, and was also less than at the rest LV walls in the same group (P < 0.01). The systolic reversed epsilon(et) was noticed in 35% of the hypertrophic segments in HCM group. Significantly negative correlation existed between the absolute value of epsilon(et) and wall thickness in the midseptum (r = -0.83). The post-systolic strain (PSS) segment number the and amplitudes in healthy group were significantly less than those in HCM group (P < 0.05). Both regional myocardial systolic and diastolic functions were impaired in hypertrophic or non-hypertrophic segments in patients with the HCM, especially in hypertrophic segments. Strain imaging technique is a sensitive and accura tool in myocardial dysfunction assessment.