Four-Dimensional Speckle Tracking Echocardiography in Patients with Hypertrophic Cardiomyopathy

Objective Abnormal left ventricular (LV) deformational mechanics have been demonstrated in patients with hypertrophic cardiomyopathy (HCM) using two-dimensional (2D) speckle tracking echocardiography, but there is not enough information about the four-dimensional speckle tracking echocardiography (4DSTE) in these patients. The objective of the study was to identify and quantify the left ventricular contractility in patients with HCM using 4DSTE. Methods Thirty patients [age, 54.612.1years; 12 (40%) women] with diagnosis of nonobstructive HCM and 20 healthy controls [age, 47.4211.43years; 8 (40%) women] underwent 4DSTE measurement of longitudinal, radial, circumferential, and area strains. Results Patients with HCM showed lower longitudinal (-13.5% vs. -20.3%, P<0.001) and radial (33.4% vs. 43.6%, P<0.001) strain, but higher circumferential (-22.7% vs. -15.9%, P<0.001) and area (-30.7% vs. -22.1%, P<0.001) strain than control subjects. Peak LV twist showed significantly higher values in patients with HCM (13.7 +/- 5.3 vs. 11.3 +/- 4.8, P<0.005). Conclusions Patients with HCM have reduced longitudinal and radial strain but increased circumferential and area strain on 4DSTE. These results are found appropriate with previous 2DSTE studies. Thus, 4DSTE is useful to determine LV deformational mechanics.