Impact of Septal Curvature on Regional Strain in Patients With Hypertrophic Cardiomyopathy

Katsuji Inoue; Hideki Okayama; Kazuhisa Nishimura; Takayuki Nagai; Jun Suzuki; Akiyoshi Ogimoto; Makoto Saito; Toyofumi Yoshii; Go Hiasa; Takumi Sumimoto; Jun-ichi Funada; Yuji Shigematsu; Mareomi Hamada; Jitsuo Higaki

doi:10.1253/circj.CJ-12-0752

Myocardial Disease

Impact of Septal Curvature on Regional Strain in Patients With Hypertrophic Cardiomyopathy

Katsuji Inoue, Hideki Okayama, Kazuhisa Nishimura, Takayuki Nagai, Jun Suzuki, Akiyoshi Ogimoto, Makoto Saito, Toyofumi Yoshii, Go Hiasa, Takumi Sumimoto, Jun-ichi Funada, Yuji Shigematsu, Mareomi Hamada, Jitsuo Higaki

Author information

Katsuji Inoue
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Hideki Okayama
Department of Cardiology, Ehime Prefectural Central Hospital
Kazuhisa Nishimura
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Takayuki Nagai
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Jun Suzuki
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Akiyoshi Ogimoto
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Makoto Saito
Department of Cardiology, Kitaishikai Hospital
Toyofumi Yoshii
Department of Cardiology, Kitaishikai Hospital
Go Hiasa
Department of Cardiology, Kitaishikai Hospital
Takumi Sumimoto
Department of Cardiology, Kitaishikai Hospital
Jun-ichi Funada
Department of Cardiology, Ehime National Hospital
Yuji Shigematsu
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine
Mareomi Hamada
Department of Cardiology, Uwajima City Hospital
Jitsuo Higaki
Division of Cardiology, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine

Keywords: Catenoid configuration, Hypertrophic cardiomyopathy, Longitudinal strain, Septal curvature, Speckle tracking echocardiography

JOURNAL FREE ACCESS

2013 Volume 77 Issue 4 Pages 1040-1045

DOI https://doi.org/10.1253/circj.CJ-12-0752

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Abstract

Background: The interventricular septum in hypertrophic cardiomyopathy (HC) has a unique shape, which is characterized by the convex curvature toward the left ventricle (LV). The aim of this study was to examine the relationship between curvature of the LV wall and regional myocardial strain. Methods and Results: Fifty-six patients with HC (mean age, 55±12 years) and 20 age- and sex-matched control subjects (mean age, 56±8 years) were enrolled. The curvature index (1/radius) was measured by drawing along the endocardial surface from the apical 4-chamber and short axis views. Peak systolic strain was calculated in the septal and lateral walls using 2-D speckle tracking echocardiography. The septal curvature index and septal longitudinal strain were significantly lower in the HC group than in the control group. A multivariate model using the HC patient data showed that the septal curvature index and septal thickness were the independent determinants of septal longitudinal strain (septal curvature index: β=–0.421, P<0.001; septal thickness: β=0.401, P=0.002). In addition, global longitudinal strain and E/e’ were worse in the lower septal curvature index group compared with the higher group. Conclusions: Septal longitudinal strain is associated with the degree of septal curvature. This indicates a possible link between LV wall configuration and regional myocardial function. (Circ J 2013; 77: 1040–1045)

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