medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1469medvis-1469Research ArticleСЕРДЦЕ И СОСУДЫHEART AND VESSELSЭхокардиографическая оценка структурных и функциональных свойств левого желудочка у детей с гипертрофической кардиомиопатиейEchocardiographic assessment of the structural and functional properties of the left ventricle in children with hypertrophic cardiomyopathyhttps://orcid.org/0000-0003-0513-9012СоколовА. А.SokolovA. A.

Соколов Александр Анатольевич – доктор мед. наук, профессор, заведующий лабораторией ультразвуковых и функциональных методов исследования Научно-исследовательского института кардиологии Томского национального исследовательского медицинского центра РАН, Томск. https://orcid.org/0000-0003-0513-9012

Alexander A. Sokolov – Doct. of Sci. (Med.), Professor, Head of the Department of Functional and Laboratory Diagnostics, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk. https://orcid.org/0000-0003-0513-9012

falco16@yandex.ruhttps://orcid.org/0000-0002-0493-4762КожановР. С.KozhanovR. S.

Кожанов Роман Сергеевич – врач сердечно-сосудистый хирург Научно-исследовательского института кардиологии, Томского национального исследовательского медицинского центра РАН, Томск. https://orcid.org/0000-0002-0493-4762

Roman S. Kozhanov – cardiovascular surgeon, Surgery, Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk, Russia. https://orcid.org/0000-0002-0493-4762

romankozhanoff@yandex.ruhttps://orcid.org/0000-0003-4023-455XЕгуновО. А.EgunovO. A.

Егунов Олег Анатольевич – канд. мед. наук, врач сердечно-сосудистый хирург, научный сотрудник отделения сердечно-сосудистой хирургии Научно-исследовательского института кардиологии Томского национального исследовательского медицинского центра РАН, Томск. https://orcid.org/0000-0003-4023-455X

Оleg A. Egunov – Cand. of Sci. (Med.), cardiovascular surgeon, Researcher of Department of Cardiovascular Surgery, Cardiology Research Institute, Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk. https://orcid.org/0000-0003-4023-455X

egunov_oleg@mail.ruhttps://orcid.org/0000-0002-0828-3995КривощековЕ. В.KrivoshchekovE. V.

Кривощеков Евгений Владимирович – доктор мед. наук, заведующий кардиохирургическим отделением №3, врач сердечно-сосудистый хирург ФГБУ “Федеральный центр высоких медицинских технологий” Минздрава России, Калининград. https://orcid.org/0000-0002-0828-3995

Evgeny V. Krivoshchekov – Doct. of Sci. (Med.), Head of Cardiac Surgery Department No 3, cardiovascular surgeon, Federal Center for High Medical Technologies of the Ministry of Health of the Russian Federation, Kaliningrad. https://orcid.org/0000-0002-0828-3995

kev-md@yandex.ruНаучно-исследовательский институт кардиологии Томского национального исследовательского медицинского центра РАН; 634012 Томск, ул. Киевская, 111-А, Российская ФедерацияРоссияCardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences; 111a, Kievskaya str., Tomsk 634012, Russian FederationRussian FederationФГБУ “Федеральный центр высоких медицинских технологий” Минздрава России; 236035 Калининград, Калининградское шоссе, д. 4, Российская ФедерацияРоссияFederal Center for High Medical Technologies of the Ministry of Health of the Russian Federation; 4, Kaliningradskoye shosse, Kaliningrad 236035, Russian FederationRussian Federation2024031120242844756Copyright © Соколов А.А., Кожанов Р.С., Егунов О.А., Кривощеков Е.В., 20242024Соколов А.А., Кожанов Р.С., Егунов О.А., Кривощеков Е.В.Sokolov A.A., Kozhanov R.S., Egunov O.A., Krivoshchekov E.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.vidar.ru/jour/article/view/1469Цель исследования

Цель исследования: анализ структурных и систолодиастолических характеристик левых камер сердца у детей с обструктивной гипертрофической кардиомиопатией (ГКМП).

Материал и методы

Материал и методы. Выполнено комплексное ретроспективное сравнительное эхокардиографическое исследование детей с обструктивной формой ГКМП в возрасте 1–17 лет (n = 52) и контрольной группы (n = 1060) здоровых детей того же возраста.

Результаты

Результаты. Проанализированы основные показатели структурных и систолодиастолических свойств левых камер сердца у детей двух групп. Помимо этого, у пациентов с ГКМП оценивалась корреляционная связь показателей систолической и диастолической функции левого желудочка (ЛЖ) с толщиной межжелудочковой перегородки (МЖП). Большинство показателей, характеризующих систолические свойства ЛЖ, не имели корреляционных связей с увеличением толщины МЖП. Диастолические параметры – скорость расслабления миокарда в фазу быстрого наполнения, определенная по тканевому допплеровскому режиму (е), и давление наполнения ЛЖ статистически значимо коррелировали с увеличением толщины МЖП.

Выводы

Выводы. Эхокардиография у детей с обструктивной ГКМП остается “золотым стандартом” диагностики, позволяющим комплексно оценить основные структурные характеристики камер сердца.

Aim

Aim. Analysis of the structural and systole-diastolic characteristics of the left chambers of the heart in children with obstructive hypertrophic cardiomyopathy.

Materials and methods

Materials and methods. A comprehensive retrospective comparative echocardiographic study of children with obstructive HCM aged 1–17 years (n = 52) and a control group (n = 1060) of healthy children of the same age was performed.

Results

Results. The main indicators of the structural and systole-diastolic properties of the left chambers of the heart in children of two groups were analyzed. In addition, in patients with HCM, the correlation between parameters of systolic and diastolic function of the left ventricle and the thickness of the interventricular septum was assessed. Most of the indicators characterizing the systolic properties of the LV had no correlation with an increase in the thickness of the IVS. Diastolic parameters – the rate of myocardial relaxation during the rapid filling phase, determined by tissue Doppler mode (e), and LV filling pressure – statistically significantly correlated with an increase in IVS thickness.

Conclusions

Conclusions. Echocardiography in children with obstructive HCM remains the gold standard for diagnosis, allowing a comprehensive assessment of the main structural characteristics of the heart chambers.

гипертрофическая кардиомиопатиягемодинамика гипертрофической кардиомиопатииэхокардиографияhypertrophic cardiomyopathyhemodynamics of hypertrophic cardiomyopathyechocardiographyReferencesLipshultz S.E., Sleeper L.A., Towbin J.A., et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N. Engl. J. Med. 2003; 348 (17): 1647–1655. https://doi.org/10.1056/NEJMoa021715Lipshultz S.E., Sleeper L.A., Towbin J.A., et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N. Engl. J. Med. 2003; 348 (17): 1647–1655. https://doi.org/10.1056/NEJMoa021715Menon S.C., Eidem B.W., Dearani J.A. et al. Diastolic dysfunction and its histopathological correlation in obstructive hypertrophic cardiomyopathy in children and adolescents. J. Am. Soc. Echocardiogr. 2009; 22 (12): 1327–1334. https://doi.org/10.1016/j.echo.2009.08.014Menon S.C., Eidem B.W., Dearani J.A. et al. Diastolic dysfunction and its histopathological correlation in obstructive hypertrophic cardiomyopathy in children and adolescents. J. Am. Soc. Echocardiogr. 2009; 22 (12): 1327–1334. https://doi.org/10.1016/j.echo.2009.08.014Maron B.J. Clinical course and management of hypertrophic cardiomyopathy. N. Engl. J. Med. 2018; 379 (7): 655–668. https://doi.org/10.1056/nejmra1710575Maron B.J. Clinical course and management of hypertrophic cardiomyopathy. N. Engl. J. Med. 2018; 379 (7): 655–668. https://doi.org/10.1056/nejmra1710575Maron B.J., Ferrans V.J., Henry W.L. et al. Differences in distribution of myocardial abnormalities in patients with obstructive and nonobstructive asymmetric septal hypertrophy (ASH): light and electron microscopic findings. Circulation. 1974; 50 (3): 436–446. https://doi.org/10.1161/01.cir.50.3.436Maron B.J., Ferrans V.J., Henry W.L. et al. Differences in distribution of myocardial abnormalities in patients with obstructive and nonobstructive asymmetric septal hypertrophy (ASH): light and electron microscopic findings. Circulation. 1974; 50 (3): 436–446. https://doi.org/10.1161/01.cir.50.3.436Ibrahim M., Rao C., Ashrafian H. et al. Modern management of systolic anterior motion of the mitral valve. Eur. J. Cardiothorac. Surg. 2012; 41 (6): 1260–1270. http://doi:10.1093/ejcts/ezr232Ibrahim M., Rao C., Ashrafian H. et al. Modern management of systolic anterior motion of the mitral valve. Eur. J. Cardiothorac. Surg. 2012; 41 (6): 1260–1270. http://doi:10.1093/ejcts/ezr232Tei C., Ling L.H., Hodge D.O. et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function – a study in normals and dilated cardiomyopathy. J. Cardiol. 1995; 26 (6): 357–366.Tei C., Ling L.H., Hodge D.O. et al. New index of combined systolic and diastolic myocardial performance: a simple and reproducible measure of cardiac function – a study in normals and dilated cardiomyopathy. J. Cardiol. 1995; 26 (6): 357–366.Chung N., Nishimura R.A., Holmes D.R. et al. Measurement of left ventricular dp/dt by simultaneous Doppler echocardiography and cardiac catheterization. J. Am. Soc. Echocardiogr. 1992; 5 (2): 147–152. http://doi:10.1016/s0894-7317(14)80544-0Chung N., Nishimura R.A., Holmes D.R. et al. Measurement of left ventricular dp/dt by simultaneous Doppler echocardiography and cardiac catheterization. J. Am. Soc. Echocardiogr. 1992; 5 (2): 147–152. http://doi:10.1016/s0894-7317(14)80544-0Anthony C., Akintoye E., Wang T. et al. Echo Doppler parameters of diastolic function. Curr. Cardiol. Rep. 2023; 25 (4): 235–247. http://doi: 10.1007/s11886-023-01844-3Anthony C., Akintoye E., Wang T. et al. Echo Doppler parameters of diastolic function. Curr. Cardiol. Rep. 2023; 25 (4): 235–247. http://doi: 10.1007/s11886-023-01844-3Bjork V.O., Hultquist G., Lodin H. Subaortic stenosis produced by an abnormally placed anterior mitral leaflet. J. Thorac. Cardiovasc. Surg. 1961; 41 (5): 659–669. https://doi.org/10.1016/S0022-5223(20)31663-9Bjork V.O., Hultquist G., Lodin H. Subaortic stenosis produced by an abnormally placed anterior mitral leaflet. J. Thorac. Cardiovasc. Surg. 1961; 41 (5): 659–669. https://doi.org/10.1016/S0022-5223(20)31663-9Pollick C., Morgan C.D., Gilbert B.W. et al. Muscular subaortic stenosis: the temporal relationship between systolic anterior motion of the anterior mitral leaflet and the pressure gradient. Circulation. 1982; 66 (5): 1087–1094. https://doi.org/10.1161/01.cir.66.5.1087Pollick C., Morgan C.D., Gilbert B.W. et al. Muscular subaortic stenosis: the temporal relationship between systolic anterior motion of the anterior mitral leaflet and the pressure gradient. Circulation. 1982; 66 (5): 1087–1094. https://doi.org/10.1161/01.cir.66.5.1087Hiemstra Y.L., Debonnaire P., Bootsma M. et al. Global longitudinal strain and left atrial volume index provide incremental prognostic value in patients with hypertrophic cardiomyopathy. Circ. Cardiovasc. Imaging. 2017; 10 (7): e005706. https://doi.org/10.1161/circimaging.116.005706Hiemstra Y.L., Debonnaire P., Bootsma M. et al. Global longitudinal strain and left atrial volume index provide incremental prognostic value in patients with hypertrophic cardiomyopathy. Circ. Cardiovasc. Imaging. 2017; 10 (7): e005706. https://doi.org/10.1161/circimaging.116.005706Turkbey E.B., McClelland R.L., Kronmal R.A. et al. The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC Cardiovasc. Imaging. 2010; 3 (3): 266–274. https://doi.org/10.1016/j.jcmg.2009.10.012Turkbey E.B., McClelland R.L., Kronmal R.A. et al. The impact of obesity on the left ventricle: the Multi-Ethnic Study of Atherosclerosis (MESA). JACC Cardiovasc. Imaging. 2010; 3 (3): 266–274. https://doi.org/10.1016/j.jcmg.2009.10.012Olivotto I., Maron B.J., Tomberli B. et al. Obesity and its association to phenotype and clinical course in hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 2013; 62 (5): 449–457. https://doi.org/10.1016/j.jacc.2013.03.062Olivotto I., Maron B.J., Tomberli B. et al. Obesity and its association to phenotype and clinical course in hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 2013; 62 (5): 449–457. https://doi.org/10.1016/j.jacc.2013.03.062Haland T.F., Hasselberg N.E., Almaas V.M. et al. The systolic paradox in hypertrophic cardiomyopathy. Open Heart. 2017; 4 (1): e000571. https://doi.org/10.1136/openhrt-2016-000571Haland T.F., Hasselberg N.E., Almaas V.M. et al. The systolic paradox in hypertrophic cardiomyopathy. Open Heart. 2017; 4 (1): e000571. https://doi.org/10.1136/openhrt-2016-000571Mejia A.S., Simpson E.K., Hildebolt C.F. et al. Tissue dopplerseptal tei index indicatesseverity of illness in pediatric patients with congestive heart failure. Pediatr. Cardiol. 2014; 35 (3): 411–418. https://doi.org/10.1007/s00246-013-0794-1Mejia A.S., Simpson E.K., Hildebolt C.F. et al. Tissue dopplerseptal tei index indicatesseverity of illness in pediatric patients with congestive heart failure. Pediatr. Cardiol. 2014; 35 (3): 411–418. https://doi.org/10.1007/s00246-013-0794-1Bruch C., Schmermund A., Dagres N. et al. Tei-index in symptomatic patients with primary and secondary mitral regurgitation. Int. J. Cardiovasc. Imaging. 2002; 18 (2): 101–110. https://doi.org/10.1023/a:1014664418322Bruch C., Schmermund A., Dagres N. et al. Tei-index in symptomatic patients with primary and secondary mitral regurgitation. Int. J. Cardiovasc. Imaging. 2002; 18 (2): 101–110. https://doi.org/10.1023/a:1014664418322Zhang M.K., Zhang Z., Xue H. et al. Microvascular rarefaction and myocardial fibrosis in hypertrophic obstructive cardiomyopathy: A histopathological comparison of pediatric and adult patients. Heart Surg. Forum. 2022; 25 (1): E042–E047. https://doi.org/10.1532/hsf.4277Zhang M.K., Zhang Z., Xue H. et al. Microvascular rarefaction and myocardial fibrosis in hypertrophic obstructive cardiomyopathy: A histopathological comparison of pediatric and adult patients. Heart Surg. Forum. 2022; 25 (1): E042–E047. https://doi.org/10.1532/hsf.4277Dragulescu A., Mertens L., Friedberg M.K. Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ. Cardiovasc. Imaging. 2013; 6 (2): 254–261. https://doi.org/10.1161/circimaging.112.000175Dragulescu A., Mertens L., Friedberg M.K. Interpretation of left ventricular diastolic dysfunction in children with cardiomyopathy by echocardiography: problems and limitations. Circ. Cardiovasc. Imaging. 2013; 6 (2): 254–261. https://doi.org/10.1161/circimaging.112.000175Bertacchini F., Rosei C.A., Buso G., et al. Subclinical HMOD in hypertension: Left ventricular diastolic dysfunction. High Blood Press. Cardiovasc. Prev. 2022; 29 (6): 585–593. https://doi.org/10.1007%2Fs40292-022-00548-zBertacchini F., Rosei C.A., Buso G., et al. Subclinical HMOD in hypertension: Left ventricular diastolic dysfunction. High Blood Press. Cardiovasc. Prev. 2022; 29 (6): 585–593. https://doi.org/10.1007%2Fs40292-022-00548-zLosi M.A., Nistri S., Galderisi M. et al. Echocardiography in patients with hypertrophic cardiomyopathy: usefulness of old and new techniques in the diagnosis and pathophysiological assessment. Cardiovasc. Ultrasound. 2010; 8: 7. https://doi.org/10.1186/1476-7120-8-7Losi M.A., Nistri S., Galderisi M. et al. Echocardiography in patients with hypertrophic cardiomyopathy: usefulness of old and new techniques in the diagnosis and pathophysiological assessment. Cardiovasc. Ultrasound. 2010; 8: 7. https://doi.org/10.1186/1476-7120-8-7

The authors declare that there are no conflicts of interest present.