Volume 113, Nº 4, October 2019
DOI: http://www.dx.doi.org/10.5935/abc.20190176
ORIGINAL ARTICLE
Strain Analysis of Left Ventricular Function in the Association of Hypertrophic Cardiomyopathy and Systemic Arterial Hypertension
Thereza Cristina Pereira Gil
Marcia Bueno Castier
Alyne Freitas Pereira Gondar
Ana Ferreira Sales
Marceli de Oliveira Santos
Fernanda Cristina da Silva de Lima
Ricardo Mourilhe-Rocha1
Dr. Thereza Cristina Pereira Gil
![](images/strain-analysis-of-left-ventricular-function-in-the-association-of-hypertrophic-cardiomyopathy-and-systemic-arterial-hypertension.jpg)
Figure 3 – Global longitudinal strain systolic peak curves in the four-chamber apical section (left) and the parametric image of the left ventricle in the bulls-eye (right) in a patient with HCM and hypertension.
Abstract
Background: Hypertrophic cardiomyopathy (HCM) is the most common heart disease of genetic origin in the world population, with a prevalence of at least 1/500. The association with systemic arterial hypertension (SAH) is not uncommon, as it affects approximately 25% of the world population. Most studies aim at the differential diagnosis between these diseases, but little is known about the magnitude of this association.
Objective: To compare left ventricular global longitudinal strain (GLS) in HCM patients with and without associated SAH.
Methods: Retrospective cross-sectional study that included 45 patients with HCM and preserved ejection fraction, with diagnosis confirmed by magnetic resonance imaging, including 14 hypertensive patients. Transthoracic echocardiography was performed, with emphasis on left ventricular myocardial strain analysis using GLS. In this study, p < 0.05 was considered statistically significant.
Results: Left ventricular strain was significantly lower in hypertensive individuals compared to normotensive individuals (–10.29 ± 2.46 vs. –12.35% ± 3.55%, p = 0.0303), indicating greater impairment of ventricular function in that group. Mean age was also significantly higher in hypertensive patients (56.1 ± 13.9 vs. 40.2 ± 12.7 years, p = 0.0001). Diastolic dysfunction was better characterized in hypertensive patients (p = 0.0242).
Conclusion: Myocardial strain was significantly lower in the group of patients with HCM and SAH, suggesting greater impairment of ventricular function. This finding may be related to a worse prognosis with early evolution to heart failure. Prospective studies are required to confirm this hypothesis. (Arq Bras Cardiol. 2019; 113(4):677-684)
Keywords: Ventricular Function, Left; Cardiomyopathy, Hypertrophic; Hypertension; Strain; Heart Failure.