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Can deformation imaging predict the occurrence of ventricular tachycardia in patients with hypertrophic cardiomyopathy?
Session:
CO 13 - Miocárdio e Pericárdio
Speaker:
Mário Rui Lourenço
Congress:
CPC 2018
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.3 Myocardial Disease – Diagnostic Methods
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Mário Lourenço; Filipa Castro; Olga Azevedo; Bebiana Faria; CARLA FERREIRA; Lucy Calvo; Sérgio Machado Leite; Isabel Nogueira; António Lourenço
Abstract
<p>Purpose:<br /> To evaluate the usefulness of myocardial deformation imaging to predict the occurrence of ventricular tachycardias<br /> (VT) in patients with asymmetric hypertrophic cardiomyopathy (HCM)</p> <p>Methods:<br /> The study included 39 patients with asymmetric HCM.<br /> Standard 2Decho,<br /> Tissue Doppler Imaging (TDI) and strain evaluation by speckle tracking were performed to<br /> evaluate LV dimension, mass and function. Holter monitoring was used to identify patients who had VT.<br /> We divided the patients in 2 groups depending on the presence of at least 1 nonsustained<br /> ventricular tachycardia<br /> (NSVT) in the Holter monitoring.</p> <p>Results:<br /> Patients were predominantly males (66,7%) with mean age of 60,6±10,3.<br /> There were no differences in distribution of age and sex between the two groups. There were also no statistically<br /> significant differences in the thickness of interventricular septum (p=0,22) or posterior wall (p=0,54) neither in left<br /> ventricular mass (LVM) (p=0,42), LVM index (p=0,44) or ejection fraction (P=0,29).<br /> No statistically significant differences were found in global longitudinal strain (p=0,15) and strain rate (p=0,63) neither<br /> in global radial strain (p=0,26) and strain rate (p=0,15).<br /> We found statistically different values of global circumferential strain (p=0,03) and strain rate (p=0,01) and mechanical<br /> dispersion (p=0,02) between the groups and multivariate regression analysis identified global circumferential strain rate<br /> (GCRS) and mechanical dispersion as independent predictors of the occurrence of NSVT (p=0,003 and p=0,007,<br /> respectively).<br /> A GCSR below the cutoff value 1,555/s predicted the occurrence of NSVT with a sensitivity of 87,5% and a specificity<br /> of 63,3% with an area under the curve (AUC) of 0,773. A mechanical dispersion above the cutoff value of 138,5ms<br /> predicted the occurrence of NSVT with a sensitivity of 87,5% and a specificity of 50% with an AUC of 0,75.</p> <p>Conclusion:<br /> Global circumferential strain and strain rate and mechanical dispersion were significantly different between HCM<br /> patients with and without evidence of NSVT.<br /> Global circumferential strain rate and mechanical dispersion were independent predictors of NSVT in patients with<br /> HCM.</p>
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