Comparision of Papillary Muscle Deformation Parameters in Patients with Hypertrophic Cardiomyopathy and Hypertension

Background The aim of the present study was to analyze anterolateral papillary muscle longitudinal strain (ALPM-St), posteromedial papillary muscle longitudinal strain (PMPM-St), anterolateral papillary muscle time to peak longitudinal strain (ALPM-time), posteromedial papillary muscle time to peak longitudinal strain (PMPM-time) and asynchrony between papillary muscles in patients with hypertrophic cardiomyopathy (HCM), hypertensive left ventricular hypertrophy (H-LVH) and normal subjects using echocardiography with 2-dimensional speckle tracking imaging (2D-STI).Methods Conventional echocardiography, tissue Doppler imaging, and 2D-STI were performed in 36 patients with HCM, 10 patients with H-LVH (New York Heart Association functional class ≤II and preserved ejection fraction) and 10 normal subjects. The significance of differences between groups was evaluated by non-parametric analysis (Mann–Whitney test).Results We summarized the results in Table 1. Variable HCM (n=36) HT (n=10) Normal (n=10) p (HCM vs HT) p (HCM vs Control) p (HT vs Control) Age 46.3±14.6 60.4±8.7 42.2±11.2 0.008* 0.49 0.001* Male/Female 21/15 7/3 8/2 0.93 0.21 0.33 Septal thickness (mm) 24.7±6 16.3±2,4 11.3±1 0.005* < 0.0001* < 0.0001* Posterior wall thickness (mm) 13.1±2.6 14.5±1.6 10.6±0.52 < 0.0001* 0.002* < 0.0001* Septum/posterior ratio 1.94±0.53 1.12±0.09 1.07±0.08 0.076 < 0.0001* 0.28 LV mass (gr) 406.8±111.7 303.2±61.5 181.4±29.8 < 0.0001* < 0.0001* < 0.0001* LV end-diastolic diameter (mm) 44.8±6.3 46.2±5.5 45.5±3 027 0.67 0.32 LV end-systolic diameter (mm) 24.7±5 26.3±5.1 25.4±2.4 0.42 0.53 0.74 Mitral E velocity (cm/s) 0.76±0.18 0.6±0.12 0.7±0.13 0.013* 0.35 0.14 Mitral A velocity (cm/s) 0.61±0.21 0.7±0.11 0.64±0.14 0.07 0.49 0.11 Mitral E Deceleration Time (ms) 193.4±64.3 225±54.4 220±50.7 0.90 0.15 0.80 Mitral Septal Sa (cm/s) 7.3±2.1 6.6±1.01 8.7±1.6 0.31 0.07 0.01* Mitral Septal Ea (cm/s) 5.06±1.6 5.5±1.7 9.4±3 0.49 < 0.0001* 0.003* Mitral Septal Aa (cm/s) 7.5±1.8 8±1.04 10.3±1.8 0.53 < 0.0001* 0.007* Mitral Lateral Sa (cm/s) 8.2±2 7.3±1.1 9.5±1.7 0.19 0.11 0.005* Mitral Lateral Ea (cm/s) 8.7±3.1 6.8±2.5 11±3.1 0.09 0.06 0.019* Mitral Lateral Aa (cm/s) 8.8±2.5 9.9±2.7 9.4±1.8 0.26 0.36 0.54 Mitral Septal E/Ea 16.2±6.1 11.9±3.3 8.1±2.8 0.09 < 0.0001* 0.019* Mitral Lateral E/Ea 9.5±3.5 9.9±2.9 6.8±2.0 0.65 0.009* 0.014* Global Longitudinal Strain (%) -10.8±2.7 -14.6±2.3 -16.3±2.0 < 0.0001* < 0.0001* 0.12 Global Radial Strain (%) 11.9±4.5 18.5±6 18.5±4.8 0.001* 0.001* 0.35