1. Distinguishing focal fibrotic lesions and non-fibrotic lesions in hypertrophic cardiomyopathy by assessment of regional myocardial strain using two-dimensional speckle tracking echocardiography: comparison with multislice CT.
- Author
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Yajima R, Kataoka A, Takahashi A, Uehara M, Saito M, Yamaguchi C, Lee K, Komuro I, and Funabashi N
- Subjects
- Adult, Aged, Cardiac Imaging Techniques methods, Cardiac Imaging Techniques standards, Cardiac Imaging Techniques statistics & numerical data, Cardiomyopathy, Hypertrophic pathology, Diagnosis, Differential, Echocardiography standards, Echocardiography statistics & numerical data, Female, Fibrosis diagnostic imaging, Humans, Male, Middle Aged, Observer Variation, Reproducibility of Results, Retrospective Studies, Tomography, X-Ray Computed standards, Tomography, X-Ray Computed statistics & numerical data, Young Adult, Cardiomyopathy, Hypertrophic diagnostic imaging, Echocardiography methods, Myocardium pathology, Tomography, X-Ray Computed methods
- Abstract
Purpose: To distinguish focal fibrotic and non-fibrotic lesions in left-ventricular myocardium (LVM) in hypertrophic-cardiomyopathy (HCM)-subjects, we compared myocardial regional peak-strain values using two-dimensional speckle-tracking transthoracic-echocardiography (TTE) in multislice computed-tomography (CT)-detected fibrotic, non-fibrotic and normal control lesions., Methods: Twenty subjects (10 consecutive HCM-subjects (8-males, mean 63.4-years), 10 healthy controls (5-males, mean 51.5-years)) underwent speckle-tracking TTE (iE-33), and analysis of regional peak-longitudinal (LS) and radial-strain (RS), and corresponding strain rates in each of 17 LVM segments (American-Heart-Association classification). In HCM-subjects, fibrotic lesions were identified by early-phase defective enhancement and late-phase abnormal enhancement by CT (Light-Speed-Ultra-16). Regional peak LS and RS at basal, mid and apical levels were measured in MSCT-detected fibrotic and non-fibrotic LVM lesions., Results: In 10 HCM subjects, 143 lesions (84.1%) yielded good tracking on TTE. Twenty lesions showed fibrotic changes in 5 subjects by CT. Regional peak-LS and RS absolute values were significantly lower in both fibrotic and non-fibrotic lesions in HCM subjects than in controls at basal, mid, apical levels (all P<0.05). While peak-LS (%) absolute values were significantly lower in fibrotic than non-fibrotic lesions at basal, mid and apical levels (all P<0.05), regional peak-RS absolute values were significantly lower only at mid levels. LS was a more sensitive indicator than the corresponding rate, with better reproducibility., Conclusions: In HCM, regional peak-LS was significantly lower in fibrotic than non-fibrotic lesions in LVM by CT. Regional peak-LS by speckle-tracking provides useful information noninvasively to distinguish fibrotic from non-fibrotic lesions in LVM in HCM and normal LVM in healthy controls., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2012
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