Assessment of regional myocardial function in patients with hypertrophic cardiomyopathy by tissue strain imaging

  • Xiong Runqing
  • Xie Mingxing
  • Wang Xinfang
  • Lü Qing


The value of tissue strain imaging (SI) in regional myocardial systolic and diastolic function assessment was studied. In 18 patients with nonobstructive hypertrophic cardiomyopathy (HCM) and 20 age-matched healthy subjects, regional myocardial longitudinal peak systolic strain in eject time (represented by εet) was measured at basal, mid and apical segments of septal, lateral and posterior walls of the left ventricle (LV) and compared between groups. εet had no significant difference between segments in control group (P>0.05), which displayed a decreasing trend from basal segments to apical ones, εet in the HCM group was significantly decreased (P<0.05) as compared with that in the healthy group. In the HCM group, εet in the midseptum was significantly less than at the basal and apical septum, and was also less than at the rest LV walls in the same group (P<0.01). The systolic reversed εet was noticed in 35% of the hypertrophic segments in HCM group. Significantly negative correlation existed between the absolute value of εet and wall thickness in the midseptum (r=−0.83). The post-systolic strain (PSS) segment number the and amplitudes in healthy group were significantly less than those in HCM group (P<0.05). Both regional myocardial systolic and diastolic functions were impaired in hypertrophic or non-hypertrophic segments in patients with the HCM, especially in hypertrophic segments. Strain imaging technique is a sensitive and accura tool in myocardial dysfunction assessment.

Key words

echocardiography tissue strain imaging hypertrophic cardiomyopathy regional myocardial function 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Klues H G, Schiffers A, Maron B Jet al. Phenotypic spectrum and patterns of left ventricular hypertrophy in hypertrophic cardiomyopathy: Morphologic observations and significance as assessed by 2D echocardiography in 600 patients. J Am Coll Cardiol, 1995, 26: 1699–1708PubMedCrossRefGoogle Scholar
  2. 2.
    Crilley J G, Boehm E A, Blair Eet al. Hypertrophic cardiomyopathy due to sarcomeric gene mutations is characterized by impaired energy metabolism irrespective of the degree of hypertrophy. J Am Coll Cardiol, 2003, 41: 1776–1782PubMedCrossRefGoogle Scholar
  3. 3.
    Wang J J, Zheng L, Du Xet al. Echocardiography evaluation of myocardial strain rate of left ventricle and its influencing factors in healthy adults. Chin J Med Imaging Technol (Chinese), 2004, 20(10): 155–1557Google Scholar
  4. 4.
    Urheim S, Edvardson T, Torp Het al. Myocardial strain by Doppler echocardiography: validation of a new method to quantify regional myocardial function. Circulation, 2000, 102: 1158–1164PubMedGoogle Scholar
  5. 5.
    Mirsky I, Parmley W W. Assessment of passive elastic stiffness for isolated heart muscle and the intact heart. Circ Res, 1973, 33(2): 233–243PubMedGoogle Scholar
  6. 6.
    Edvardsen T, Gerber B L, Garot Jet al. Quantitative assessment of intrinsic regional myocardial deformation by Doppler strain rate echocardiography in humans: validation three-dimensional tagged magnetic resonance against imaging. Circulation, 2002, 106(1): 50–56PubMedCrossRefGoogle Scholar
  7. 7.
    Nagueh S F, Bachinski L L, Meyer Det al. Tissue Doppler imaging consistently detects myocardial abnormalities in patients with hypertrophic cardiomyopathy and provides a novel means for an early diagnosis before and independently of hypertrophy. Circulation, 2001, 104(2): 128–130PubMedGoogle Scholar
  8. 8.
    Karlon W J, Covell J W, McCulloch A Det al. Automated measurement of myofiber disarray in transgenic mice with ventricular expression of ras. Anat Rec, 1998, 252(4): 612–625PubMedCrossRefGoogle Scholar
  9. 9.
    Gaiderisi M, Cicalas S, Sangiorgi Get al. Tissue Doppler derived postsystolic motion in a patient with left bundle branch block: a sign of myocardial wall asynchrony. Echocardiography, 2002, 9(1): 79–81CrossRefGoogle Scholar
  10. 10.
    Pislaru C, Anagnostopoulos P C, Seward J Bet al. Higher myocardial strain rates during isovolumic relaxation phase than during ejection characterize acutely ischemic myocardium. J Am Coll Cardiol, 2002, 40(8): 1487–1494PubMedGoogle Scholar
  11. 11.
    Jamal F, Kukulski T, Strotmann Jet al. Quantification of the spectrum of changes in regional myocardial function during acute ischemia in closed chest pigs: an ultrasonic strain rate and strain study. J Am Soc Echocardiogr, 2001, 14(9): 874–884PubMedCrossRefGoogle Scholar
  12. 12.
    Stoylen A, Heimdal A, Bjornstad Ket al. Strain rate imaging by ultrasound in the diagnosis of coronary artery disease. J Am Soc Echocardiogr, 2000, 13(12): 1053–1064PubMedCrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • Xiong Runqing
    • 1
    • 2
  • Xie Mingxing
    • 1
  • Wang Xinfang
    • 1
  • Lü Qing
    • 1
  1. 1.Department of Ultrasound, Union Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
  2. 2.Department of UltrasoundShiyan Taihe HospitalShiyanChina

Personalised recommendations