Skip to main content
Top
Published in: BMC Cardiovascular Disorders 1/2024

Open Access 01-12-2024 | Cardiomyopathy | Research

Ultrasound study of right ventricular myocardial perfusion and functional changes in hypertrophic cardiomyopathy

Authors: Shan Cao, Lingjie Yang, Liyun Liu, Yuming Mu, Lina Guan

Published in: BMC Cardiovascular Disorders | Issue 1/2024

Login to get access

Abstract

Background

To evaluate the changes of right ventricular (RV) myocardial perfusion and function in patients with hypertrophic cardiomyopathy (HCM) by myocardial contrast echocardiography (MCE) and speckle tracking (2D-STE), and to explore the relationship between RV myocardial perfusion and strain.

Methods

Conventional ultrasound, MCE and 2D-STE were performed on 29 HCM patients and 21 healthy subjects to analyze RV myocardial perfusion, RV global strain, RV free wall strain, and strain of each segment. The correlation between RV myocardial perfusion and strain was further analyzed in HCM patients.

Results

MCE results showed that the regional myocardial perfusion of the RV in HCM patients was decreased. Compared with the normal control group, the mean slope (β) in the middle and apical segments of the RV free wall, and the peak intensity (A), β, myocardial blood flow (MBF) of the ventricular septum decreased in HCM patients (P < 0.05). RV function was impaired in HCM patients. The RV global strain (RV GLS), and the strain of RV free wall and each segment were lower than those in the normal control group (P < 0.05). Correlation analysis showed that there was a certain correlation between RV myocardial perfusion and strain, such as the β of the whole RV in HCM group had a positive correlation with the strain of the middle segment of the interventricular septum (r = 0.550, P = 0.002).

Conclusions

The regional myocardial perfusion and strain of the RV in HCM patients are reduced, and there is a positive correlation between them, suggesting that the reduction of myocardial strain may be related to the impairment of myocardial microcirculation.
Literature
1.
go back to reference Geske JB, Ommen SR, Gersh BJ. Hypertrophic cardiomyopathy: clinical update. JACC Heart failure. 2018;6(5):364–75.CrossRefPubMed Geske JB, Ommen SR, Gersh BJ. Hypertrophic cardiomyopathy: clinical update. JACC Heart failure. 2018;6(5):364–75.CrossRefPubMed
2.
go back to reference Smith KM, Squiers J. Hypertrophic cardiomyopathy: an overview. Crit Care Nurs Clin North Am. 2013;25(2):263–72.CrossRefPubMed Smith KM, Squiers J. Hypertrophic cardiomyopathy: an overview. Crit Care Nurs Clin North Am. 2013;25(2):263–72.CrossRefPubMed
3.
go back to reference Tuohy CV, Kaul S, Song HK, Nazer B, Heitner SB. Hypertrophic cardiomyopathy: the future of treatment. Eur J Heart Fail. 2020;22(2):228–40.CrossRefPubMed Tuohy CV, Kaul S, Song HK, Nazer B, Heitner SB. Hypertrophic cardiomyopathy: the future of treatment. Eur J Heart Fail. 2020;22(2):228–40.CrossRefPubMed
4.
go back to reference Afonso L, Briasoulis A, Mahajan N, Kondur A, Siddiqui F, Siddiqui S, Alesh I, Cardozo S, Kottam A. Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging: a cross-sectional study. Int J Cardiovasc Imaging. 2015;31(8):1503–9.CrossRefPubMed Afonso L, Briasoulis A, Mahajan N, Kondur A, Siddiqui F, Siddiqui S, Alesh I, Cardozo S, Kottam A. Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging: a cross-sectional study. Int J Cardiovasc Imaging. 2015;31(8):1503–9.CrossRefPubMed
5.
go back to reference Brough J, Jain M, Jerves T, Kruszka P, McGuffey E. Genetic screening for hypertrophic cardiomyopathy in large, asymptomatic military cohorts. Am J Med Genet C Semin Med Genet. 2020;184(1):124–8. Brough J, Jain M, Jerves T, Kruszka P, McGuffey E. Genetic screening for hypertrophic cardiomyopathy in large, asymptomatic military cohorts. Am J Med Genet C Semin Med Genet. 2020;184(1):124–8.
6.
go back to reference Ho CY, Link MS. Predicting the future in hypertrophic cardiomyopathy. Circulation. 2018;137(10):1024–6.CrossRefPubMed Ho CY, Link MS. Predicting the future in hypertrophic cardiomyopathy. Circulation. 2018;137(10):1024–6.CrossRefPubMed
7.
go back to reference Kofflard MJ, Michels M, Krams R, Kliffen M, Geleijnse ML, Ten Cate FJ, Serruys PW. Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics. Neth Heart J. 2007;15(6):209–15.CrossRefPubMedPubMedCentral Kofflard MJ, Michels M, Krams R, Kliffen M, Geleijnse ML, Ten Cate FJ, Serruys PW. Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics. Neth Heart J. 2007;15(6):209–15.CrossRefPubMedPubMedCentral
8.
go back to reference Camici PG, Tschöpe C, Di Carli MF, Rimoldi O, Van Linthout S. Coronary microvascular dysfunction in hypertrophy and heart failure. Cardiovasc Res. 2020;116(4):806–16.CrossRefPubMed Camici PG, Tschöpe C, Di Carli MF, Rimoldi O, Van Linthout S. Coronary microvascular dysfunction in hypertrophy and heart failure. Cardiovasc Res. 2020;116(4):806–16.CrossRefPubMed
9.
go back to reference Marszalek RJ, John Solaro R, Wolska BM. Coronary arterial vasculature in the pathophysiology of hypertrophic cardiomyopathy. Pflugers Arch. 2019;471(5):769–80.CrossRefPubMed Marszalek RJ, John Solaro R, Wolska BM. Coronary arterial vasculature in the pathophysiology of hypertrophic cardiomyopathy. Pflugers Arch. 2019;471(5):769–80.CrossRefPubMed
10.
go back to reference Zheng XZ, Shi YY, Chen KQ, Qiao XL, Wang LY. Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography. Med Ultrason. 2019;21(1):56–61.CrossRefPubMed Zheng XZ, Shi YY, Chen KQ, Qiao XL, Wang LY. Evaluation of regional myocardial perfusion in methamphetamine abusers using real-time myocardial contrast echocardiography. Med Ultrason. 2019;21(1):56–61.CrossRefPubMed
11.
go back to reference Mozaffarian D, Caldwell JH. Right ventricular involvement in hypertrophic cardiomyopathy: a case report and literature review. Clin Cardiol. 2001;24(1):2–8.CrossRefPubMed Mozaffarian D, Caldwell JH. Right ventricular involvement in hypertrophic cardiomyopathy: a case report and literature review. Clin Cardiol. 2001;24(1):2–8.CrossRefPubMed
12.
go back to reference Roşca M, Călin A, Beladan CC, Enache R, Mateescu AD, Gurzun MM, Varga P, Băicuş C, Coman IM, Jurcuţ R, et al. Right ventricular remodeling, its correlates, and its clinical impact in hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2015;28(11):1329–38.CrossRefPubMed Roşca M, Călin A, Beladan CC, Enache R, Mateescu AD, Gurzun MM, Varga P, Băicuş C, Coman IM, Jurcuţ R, et al. Right ventricular remodeling, its correlates, and its clinical impact in hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2015;28(11):1329–38.CrossRefPubMed
13.
go back to reference Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, Evanovich LL, Hung J, Joglar JA, Kantor P, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e533–57.PubMed Ommen SR, Mital S, Burke MA, Day SM, Deswal A, Elliott P, Evanovich LL, Hung J, Joglar JA, Kantor P, et al. 2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2020;142(25):e533–57.PubMed
14.
go back to reference Keramida K, Lazaros G, Nihoyannopoulos P. Right ventricular involvement in hypertrophic cardiomyopathy: Patterns and implications. Hellenic J Cardiol. 2020;61(1):3–8.CrossRefPubMed Keramida K, Lazaros G, Nihoyannopoulos P. Right ventricular involvement in hypertrophic cardiomyopathy: Patterns and implications. Hellenic J Cardiol. 2020;61(1):3–8.CrossRefPubMed
15.
go back to reference Maron BJ, Wolfson JK, Epstein SE, Roberts WC. Intramural (“small vessel”) coronary artery disease in hypertrophic cardiomyopathy. J Am Coll Cardiol. 1986;8(3):545–57.CrossRefPubMed Maron BJ, Wolfson JK, Epstein SE, Roberts WC. Intramural (“small vessel”) coronary artery disease in hypertrophic cardiomyopathy. J Am Coll Cardiol. 1986;8(3):545–57.CrossRefPubMed
16.
go back to reference Luo B, Zuo H, Yu Y, Huang D. The arterial architecture of the right ventricular wall. Chin J Anat. 1989;3:194–9. Luo B, Zuo H, Yu Y, Huang D. The arterial architecture of the right ventricular wall. Chin J Anat. 1989;3:194–9.
17.
go back to reference XB L, Y D, ZH L, LX Y, QF Z, QB Z. Evaluation of microcirculation function of segmental hypertrophic myocardium by myocardial contrast echocardiography. J Clin Ultrasound in Med. 2020;22(11):4. XB L, Y D, ZH L, LX Y, QF Z, QB Z. Evaluation of microcirculation function of segmental hypertrophic myocardium by myocardial contrast echocardiography. J Clin Ultrasound in Med. 2020;22(11):4.
18.
go back to reference Urtado S, Hergault H, Binsse S, Aidan V, Ouadahi M, Szymanski C, et al. Usefulness of Longitudinal Strain Adjusted to Regional Thickness in Hypertrophic Cardiomyopathy. J Clin Med. 2022;11(8):2089. Urtado S, Hergault H, Binsse S, Aidan V, Ouadahi M, Szymanski C, et al. Usefulness of Longitudinal Strain Adjusted to Regional Thickness in Hypertrophic Cardiomyopathy. J Clin Med. 2022;11(8):2089.
19.
go back to reference Vasquez N, Ostrander BT, Lu DY, Ventoulis I, Haileselassie B, Goyal S, Greenland GV, Vakrou S, Olgin JE, Abraham TP, et al. Low left atrial strain is associated with adverse outcomes in hypertrophic cardiomyopathy patients. J Am Soc Echocardiogr. 2019;32(5):593–603.e591.CrossRefPubMed Vasquez N, Ostrander BT, Lu DY, Ventoulis I, Haileselassie B, Goyal S, Greenland GV, Vakrou S, Olgin JE, Abraham TP, et al. Low left atrial strain is associated with adverse outcomes in hypertrophic cardiomyopathy patients. J Am Soc Echocardiogr. 2019;32(5):593–603.e591.CrossRefPubMed
20.
go back to reference Satriano A, Heydari B, Guron N, Fenwick K, Cheung M, Mikami Y, Merchant N, Lydell CP, Howarth AG, Fine NM, White JA. 3-Dimensional regional and global strain abnormalities in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 2019;35(10):1913–24. Satriano A, Heydari B, Guron N, Fenwick K, Cheung M, Mikami Y, Merchant N, Lydell CP, Howarth AG, Fine NM, White JA. 3-Dimensional regional and global strain abnormalities in hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 2019;35(10):1913–24.
21.
go back to reference Negri F, Muser D, Driussi M, Sanna GD, Masè M, Cittar M, Poli S, De Bellis A, Fabris E, Puppato M, et al. Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: the STRAIN-HCM study. Int J Cardiol. 2021;345:61–7.CrossRefPubMed Negri F, Muser D, Driussi M, Sanna GD, Masè M, Cittar M, Poli S, De Bellis A, Fabris E, Puppato M, et al. Prognostic role of global longitudinal strain by feature tracking in patients with hypertrophic cardiomyopathy: the STRAIN-HCM study. Int J Cardiol. 2021;345:61–7.CrossRefPubMed
22.
go back to reference D’Andrea A, Limongelli G, Baldini L, Verrengia M, Carbone A, Di Palma E, Vastarella R, Masarone D, Tagliamonte G, Riegler L, et al. Exercise speckle-tracking strain imaging demonstrates impaired right ventricular contractile reserve in hypertrophic cardiomyopathy. Int J Cardiol. 2017;227:209–16.CrossRefPubMed D’Andrea A, Limongelli G, Baldini L, Verrengia M, Carbone A, Di Palma E, Vastarella R, Masarone D, Tagliamonte G, Riegler L, et al. Exercise speckle-tracking strain imaging demonstrates impaired right ventricular contractile reserve in hypertrophic cardiomyopathy. Int J Cardiol. 2017;227:209–16.CrossRefPubMed
23.
go back to reference Collier P, Phelan D, Klein A. A test in context: myocardial strain measured by speckle-tracking echocardiography. J Am Coll Cardiol. 2017;69(8):1043–56.CrossRefPubMed Collier P, Phelan D, Klein A. A test in context: myocardial strain measured by speckle-tracking echocardiography. J Am Coll Cardiol. 2017;69(8):1043–56.CrossRefPubMed
24.
go back to reference Sonaglioni A, Nicolosi GL, Trevisan R, Lombardo M, Grasso E, Gensini GF, Ambrosio G. The influence of pectus excavatum on cardiac kinetics and function in otherwise healthy individuals: A systematic review. Int J Cardiol. 2023;381:135–44.CrossRefPubMed Sonaglioni A, Nicolosi GL, Trevisan R, Lombardo M, Grasso E, Gensini GF, Ambrosio G. The influence of pectus excavatum on cardiac kinetics and function in otherwise healthy individuals: A systematic review. Int J Cardiol. 2023;381:135–44.CrossRefPubMed
25.
go back to reference Wang T, Deng YB, Zhu Y, Wang C, Yang HY, Xiao-Jun BI. Evaluation of correlation between regional myocardial function and perfusion in patients with hypertrophic cardiomyopathy by myocardial contrast echocardiography. Chin J Med Ultrasound (Electronic Edition). 2011;8(10):2104–10. Wang T, Deng YB, Zhu Y, Wang C, Yang HY, Xiao-Jun BI. Evaluation of correlation between regional myocardial function and perfusion in patients with hypertrophic cardiomyopathy by myocardial contrast echocardiography. Chin J Med Ultrasound (Electronic Edition). 2011;8(10):2104–10.
26.
go back to reference Laufer-Perl M, Perelman-Gvili M, Sirota Dorfman S, Baruch G, Rothschild E, Beer G, Arbel Y, Arnold JH, Rozenbaum Z, Banai S, Topilsky Y, Kapusta L. Prevalence of Right Ventricle Strain Changes following Anthracycline Therapy. Life (Basel). 2022;12(2):291. Laufer-Perl M, Perelman-Gvili M, Sirota Dorfman S, Baruch G, Rothschild E, Beer G, Arbel Y, Arnold JH, Rozenbaum Z, Banai S, Topilsky Y, Kapusta L. Prevalence of Right Ventricle Strain Changes following Anthracycline Therapy. Life (Basel). 2022;12(2):291.
27.
go back to reference Voigt JU, Cvijic M. 2- and 3-dimensional myocardial strain in cardiac health and disease. JACC Cardiovasc Imaging. 2019;12(9):1849–63.CrossRefPubMed Voigt JU, Cvijic M. 2- and 3-dimensional myocardial strain in cardiac health and disease. JACC Cardiovasc Imaging. 2019;12(9):1849–63.CrossRefPubMed
Metadata
Title
Ultrasound study of right ventricular myocardial perfusion and functional changes in hypertrophic cardiomyopathy
Authors
Shan Cao
Lingjie Yang
Liyun Liu
Yuming Mu
Lina Guan
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2024
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-024-03705-5

Other articles of this Issue 1/2024

BMC Cardiovascular Disorders 1/2024 Go to the issue