EVALUATION OF THE RIGHT VENTRICULAR FUNCTION BY STRAIN IN HYPERTROPHIC CARDIOMYOPATHY AFTER SEPTAL ABLATION

Background: Strain has been proposed as a sensitive tool to detect early systolic function abnormalities in hypertrophic cardiomyopathy (HCM). We investigated the peak shortening strain (PkS) for evaluation of early systolic function abnormalities of the right ventricle (RV) in patients with obstructive HCM after alcohol septal ablation.
Methods: We prospectively enrolled consecutive patients with HCM after alcohol septal ablation with a mild residual outflow tract gradient (<15mmHg). PkS was assessed in apical free wall of RV derived from TDI and also in basal segments of lateral, inferior and anterior wall of the left ventricle. TDI of the lateral annulus, tricuspid annular plane systolic excursion and RV dimension were measured.
Results: Fourteen patients with HCM and 16 healthy controls were evaluated. Between both groups, there were no statistically significant differences in PkS from free wall of the RV, the diameter of RV, tricuspid annular plane systolic excursion and acceleration time of the pulmonary flow. In patients with HCM the lateral tricuspid annulus velocity (E´ wave) was slower than in controls (10.6±1.67 vs 12.6±2.21; p<0.05). We found statistically significant difference in longitudinal PkS in lateral (-11.62±2.77 vs -16.63±2.76; p<0.01), inferior (-8.96±2.31 vs -12.97±3.21; p<0.01) and anterior wall (-12.58±4.32 vs -17.82±3.86; p<0.01) of the left ventricle.
Conclusion: Systolic function of RV measured by peak shortening strain is not worse in HCM after hemodynamically successful alcohol septal ablation than in healthy subjects in opposite to diastolic function of RV and systolic function of the left ventricle (measured by strain).