Echocardiographic assessment of the structural and functional properties of the left ventricle in children with hypertrophic cardiomyopathy
https://doi.org/10.24835/1607-0763-1469
Abstract
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. 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. 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. 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.
About the Authors
A. A. SokolovRussian Federation
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
R. S. Kozhanov
Russian Federation
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
O. A. Egunov
Russian Federation
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
E. V. Krivoshchekov
Russian Federation
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
References
1. Lipshultz 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/NEJMoa021715
2. Menon 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.2009.08.014
3. Maron B.J. Clinical course and management of hypertrophic cardiomyopathy. N. Engl. J. Med. 2018; 379 (7): 655–668. https://doi.org/10.1056/nejmra1710575
4. Maron 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.50.3.436
5. Ibrahim 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/ezr232
6. 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.
7. 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)80544-0
8. Anthony 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/s11886-023-01844-3
9. Bjork 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)31663-9
10. Pollick 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.66.5.1087
11. Hiemstra 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.116.005706
12. Turkbey 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.2009.10.012
13. Olivotto 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.2013.03.062
14. Haland 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-2016-000571
15. Mejia 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/s00246-013-0794-1
16. Bruch 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:1014664418322
17. Zhang 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.4277
18. Dragulescu 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.112.000175
19. Bertacchini 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-z
20. Losi 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
Supplementary files
Review
For citations:
Sokolov A.A., Kozhanov R.S., Egunov O.A., Krivoshchekov E.V. Echocardiographic assessment of the structural and functional properties of the left ventricle in children with hypertrophic cardiomyopathy. Medical Visualization. 2024;28(4):47-56. (In Russ.) https://doi.org/10.24835/1607-0763-1469