الفهرس | Only 14 pages are availabe for public view |
Abstract The aim of this study was to investigate the relationship between LV deformation using 2D-strain analysis and cardiac autonomic control as assessed by heart rate variability (HRV) in hypertrophic cardiomyopathy (HCM).Methods: 60 patients with HCM, 25(41%) were female; mean age: 38±15 y and 33 healthy volunteers were included. All patients and volunteers underwent standard echocardiographic, 2D-strain examination and continuous 24-h ambulatory ECG monitoring. Time domain variables were considered in this study and its relation to longitudinal strain (εsys) and mechanical dyssynchrony (TTP-SD) in addition to other conventional echocardiographic measures were analyzed.Results: HCM had lower global and regional peak LV εsys and strain rate (SR) at the level of all analyzed segments in comparison to control (P<.001) HCM patients had significantly lower SDNN& SDANN and RMSSD compared to control (P<.001, .001, 0.01) respectively. SDNN was inversely correlated to age (r=-.31, P<.004), BSA (r=-.25, P<.01) LVOT gradient (r=-.23,P<.02) and directly correlated to E/A ratio, (r=.28, P<.005) and εsys of LV wall segments(r=.24, P<.04, r=.23, P<.02). While the rMSSD was correlated only to εsys of basal septum (r=.23, P<.02), it was inversely related to LV dyssynchrony. from all these variables only age CI: 1.029-1.161, β: 1.093, P<.004 and TTP-SD; CI: .998-1, β= .994, P<.04 were independent predictor to altered HRV in HCM patients. So a lower HRV observed in HCM is directly correlated to LV longitudinal deformation and independently related to electromechanical dyssynchrony. |