Myocardial Work in Apical Hypertrophic Cardiomyopathy
Pressure-strain loop analysis is a novel echocardiographic technique to calculate myocardial work indices that has not been applied to patients with apical hypertrophic cardiomyopathy (ApHCM). We hypothesized that myocardial work indices differ between patients with ApHCM and those with non-ApHCM. T...
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| Veröffentlicht in: | Journal of the American Society of Echocardiography 2023-10, Vol.36 (10), p.1043-1054.e3 |
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| creator | Peters, Matthew Jan, M. Fuad Ashraf, Muddasir Sanders, Heather Roemer, Sarah Schweitzer, McKenzie Adefisoye, James Galazka, Patrycja Jain, Renuka Jahangir, Arshad Khandheria, Bijoy Tajik, A. Jamil |
| description | Pressure-strain loop analysis is a novel echocardiographic technique to calculate myocardial work indices that has not been applied to patients with apical hypertrophic cardiomyopathy (ApHCM). We hypothesized that myocardial work indices differ between patients with ApHCM and those with non-ApHCM. This study aimed to (1) evaluate myocardial work indices in patients with ApHCM compared with those with non-ApHCM, (2) describe associations with relevant clinical variables, and (3) examine associations with significant late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging.
We retrospectively identified 48 patients with ApHCM and 69 with non-ApHCM who had measurements of global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. We evaluated available cardiac magnetic resonance imaging data on 34 patients with ApHCM and 51 with non-ApHCM. Multivariable regression models correcting for traditional cardiac risk factors were used to evaluate the associations of myocardial work indices with relevant clinical variables.
Median GLS (−11% vs −18%, P |
| doi_str_mv | 10.1016/j.echo.2023.06.013 |
| format | Article |
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We retrospectively identified 48 patients with ApHCM and 69 with non-ApHCM who had measurements of global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. We evaluated available cardiac magnetic resonance imaging data on 34 patients with ApHCM and 51 with non-ApHCM. Multivariable regression models correcting for traditional cardiac risk factors were used to evaluate the associations of myocardial work indices with relevant clinical variables.
Median GLS (−11% vs −18%, P < .001), GWI (966 mm Hg% vs 1803 mm Hg%, P < .001), and GCW (1,050 mm Hg% vs 1,988 mm Hg%, P < .001) were significantly impaired in patients with ApHCM compared with those with non-ApHCM. Increasing N-terminal pro b-type natriuretic peptide, abnormal ultrasensitive troponin, and increasing maximal left ventricular wall thickness were significantly associated with reduced GWI and GCW in patients with ApHCM (P < .05). Global constructive work had only modest accuracy (area under the curve [AUC] = 0.70) to predict LGE in patients with ApHCM. However, in patients with non-ApHCM, GLS was the strongest predictor of LGE (AUC = 0.91), with a −17% cutoff yielding 81% sensitivity and 80% specificity.
Myocardial work indices are significantly impaired in patients with ApHCM compared to those with non-ApHCM and correlate with important clinical variables. Global longitudinal strain, GWI, and GCW are more strongly predictive of fibrosis in patients with non-ApHCM than ApHCM.
•Myocardial work is a novel transthoracic echo method to evaluate LV performance.•Forty-eight patients with ApHCM were assessed.•Those with ApHCM had impaired work indices compared with non-ApHCM.•Work indices were associated with important clinical and imaging variables.•GLS was a strong predictor of fibrosis in non-ApHCM.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2023.06.013</identifier><identifier>PMID: 37406714</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Apical aneurysm ; Apical hypertrophic cardiomyopathy ; Cardiac magnetic resonance imaging ; Echocardiography ; Myocardial work</subject><ispartof>Journal of the American Society of Echocardiography, 2023-10, Vol.36 (10), p.1043-1054.e3</ispartof><rights>2023 American Society of Echocardiography</rights><rights>Copyright © 2023 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c356t-376afadddb82d8d5e1f14c6a9f8433688f4b324ce03ecdd638065ae24db3f6903</citedby><cites>FETCH-LOGICAL-c356t-376afadddb82d8d5e1f14c6a9f8433688f4b324ce03ecdd638065ae24db3f6903</cites><orcidid>0000-0002-4784-1275</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.echo.2023.06.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37406714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Peters, Matthew</creatorcontrib><creatorcontrib>Jan, M. Fuad</creatorcontrib><creatorcontrib>Ashraf, Muddasir</creatorcontrib><creatorcontrib>Sanders, Heather</creatorcontrib><creatorcontrib>Roemer, Sarah</creatorcontrib><creatorcontrib>Schweitzer, McKenzie</creatorcontrib><creatorcontrib>Adefisoye, James</creatorcontrib><creatorcontrib>Galazka, Patrycja</creatorcontrib><creatorcontrib>Jain, Renuka</creatorcontrib><creatorcontrib>Jahangir, Arshad</creatorcontrib><creatorcontrib>Khandheria, Bijoy</creatorcontrib><creatorcontrib>Tajik, A. Jamil</creatorcontrib><title>Myocardial Work in Apical Hypertrophic Cardiomyopathy</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Pressure-strain loop analysis is a novel echocardiographic technique to calculate myocardial work indices that has not been applied to patients with apical hypertrophic cardiomyopathy (ApHCM). We hypothesized that myocardial work indices differ between patients with ApHCM and those with non-ApHCM. This study aimed to (1) evaluate myocardial work indices in patients with ApHCM compared with those with non-ApHCM, (2) describe associations with relevant clinical variables, and (3) examine associations with significant late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging.
We retrospectively identified 48 patients with ApHCM and 69 with non-ApHCM who had measurements of global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. We evaluated available cardiac magnetic resonance imaging data on 34 patients with ApHCM and 51 with non-ApHCM. Multivariable regression models correcting for traditional cardiac risk factors were used to evaluate the associations of myocardial work indices with relevant clinical variables.
Median GLS (−11% vs −18%, P < .001), GWI (966 mm Hg% vs 1803 mm Hg%, P < .001), and GCW (1,050 mm Hg% vs 1,988 mm Hg%, P < .001) were significantly impaired in patients with ApHCM compared with those with non-ApHCM. Increasing N-terminal pro b-type natriuretic peptide, abnormal ultrasensitive troponin, and increasing maximal left ventricular wall thickness were significantly associated with reduced GWI and GCW in patients with ApHCM (P < .05). Global constructive work had only modest accuracy (area under the curve [AUC] = 0.70) to predict LGE in patients with ApHCM. However, in patients with non-ApHCM, GLS was the strongest predictor of LGE (AUC = 0.91), with a −17% cutoff yielding 81% sensitivity and 80% specificity.
Myocardial work indices are significantly impaired in patients with ApHCM compared to those with non-ApHCM and correlate with important clinical variables. Global longitudinal strain, GWI, and GCW are more strongly predictive of fibrosis in patients with non-ApHCM than ApHCM.
•Myocardial work is a novel transthoracic echo method to evaluate LV performance.•Forty-eight patients with ApHCM were assessed.•Those with ApHCM had impaired work indices compared with non-ApHCM.•Work indices were associated with important clinical and imaging variables.•GLS was a strong predictor of fibrosis in non-ApHCM.</description><subject>Apical aneurysm</subject><subject>Apical hypertrophic cardiomyopathy</subject><subject>Cardiac magnetic resonance imaging</subject><subject>Echocardiography</subject><subject>Myocardial work</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kEFLwzAYhoMobk7_gAfZ0Uvrl6ZNE_Ayhjph4kXxGLLkK8tsl5p0Qv-9HZsePX288LwvfA8h1xRSCpTfbVI0a59mkLEUeAqUnZAxBVkmvJTFKRmDkHlSMlqOyEWMGwAoBMA5GbEyB17SfEyKl94bHazT9fTDh8-p205nrTNDXPQthi74du3MdL5nfNP7Vnfr_pKcVbqOeHW8E_L--PA2XyTL16fn-WyZGFbwLmEl15W21q5EZoUtkFY0N1zLSuSMcSGqfMWy3CAwNNZyJoAXGrPcrljFJbAJuT3stsF_7TB2qnHRYF3rLfpdVJlgTEopCjmg2QE1wccYsFJtcI0OvaKg9rrURu11qb0uBVwNuobSzXF_t2rQ_lV-_QzA_QHA4ctvh0FF43Br0LqAplPWu__2fwB803ti</recordid><startdate>20231001</startdate><enddate>20231001</enddate><creator>Peters, Matthew</creator><creator>Jan, M. Fuad</creator><creator>Ashraf, Muddasir</creator><creator>Sanders, Heather</creator><creator>Roemer, Sarah</creator><creator>Schweitzer, McKenzie</creator><creator>Adefisoye, James</creator><creator>Galazka, Patrycja</creator><creator>Jain, Renuka</creator><creator>Jahangir, Arshad</creator><creator>Khandheria, Bijoy</creator><creator>Tajik, A. Jamil</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4784-1275</orcidid></search><sort><creationdate>20231001</creationdate><title>Myocardial Work in Apical Hypertrophic Cardiomyopathy</title><author>Peters, Matthew ; Jan, M. Fuad ; Ashraf, Muddasir ; Sanders, Heather ; Roemer, Sarah ; Schweitzer, McKenzie ; Adefisoye, James ; Galazka, Patrycja ; Jain, Renuka ; Jahangir, Arshad ; Khandheria, Bijoy ; Tajik, A. Jamil</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c356t-376afadddb82d8d5e1f14c6a9f8433688f4b324ce03ecdd638065ae24db3f6903</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Apical aneurysm</topic><topic>Apical hypertrophic cardiomyopathy</topic><topic>Cardiac magnetic resonance imaging</topic><topic>Echocardiography</topic><topic>Myocardial work</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Peters, Matthew</creatorcontrib><creatorcontrib>Jan, M. Fuad</creatorcontrib><creatorcontrib>Ashraf, Muddasir</creatorcontrib><creatorcontrib>Sanders, Heather</creatorcontrib><creatorcontrib>Roemer, Sarah</creatorcontrib><creatorcontrib>Schweitzer, McKenzie</creatorcontrib><creatorcontrib>Adefisoye, James</creatorcontrib><creatorcontrib>Galazka, Patrycja</creatorcontrib><creatorcontrib>Jain, Renuka</creatorcontrib><creatorcontrib>Jahangir, Arshad</creatorcontrib><creatorcontrib>Khandheria, Bijoy</creatorcontrib><creatorcontrib>Tajik, A. Jamil</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Peters, Matthew</au><au>Jan, M. Fuad</au><au>Ashraf, Muddasir</au><au>Sanders, Heather</au><au>Roemer, Sarah</au><au>Schweitzer, McKenzie</au><au>Adefisoye, James</au><au>Galazka, Patrycja</au><au>Jain, Renuka</au><au>Jahangir, Arshad</au><au>Khandheria, Bijoy</au><au>Tajik, A. Jamil</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Myocardial Work in Apical Hypertrophic Cardiomyopathy</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2023-10-01</date><risdate>2023</risdate><volume>36</volume><issue>10</issue><spage>1043</spage><epage>1054.e3</epage><pages>1043-1054.e3</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Pressure-strain loop analysis is a novel echocardiographic technique to calculate myocardial work indices that has not been applied to patients with apical hypertrophic cardiomyopathy (ApHCM). We hypothesized that myocardial work indices differ between patients with ApHCM and those with non-ApHCM. This study aimed to (1) evaluate myocardial work indices in patients with ApHCM compared with those with non-ApHCM, (2) describe associations with relevant clinical variables, and (3) examine associations with significant late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging.
We retrospectively identified 48 patients with ApHCM and 69 with non-ApHCM who had measurements of global longitudinal strain (GLS), global work index (GWI), global constructive work (GCW), global wasted work, and global work efficiency. We evaluated available cardiac magnetic resonance imaging data on 34 patients with ApHCM and 51 with non-ApHCM. Multivariable regression models correcting for traditional cardiac risk factors were used to evaluate the associations of myocardial work indices with relevant clinical variables.
Median GLS (−11% vs −18%, P < .001), GWI (966 mm Hg% vs 1803 mm Hg%, P < .001), and GCW (1,050 mm Hg% vs 1,988 mm Hg%, P < .001) were significantly impaired in patients with ApHCM compared with those with non-ApHCM. Increasing N-terminal pro b-type natriuretic peptide, abnormal ultrasensitive troponin, and increasing maximal left ventricular wall thickness were significantly associated with reduced GWI and GCW in patients with ApHCM (P < .05). Global constructive work had only modest accuracy (area under the curve [AUC] = 0.70) to predict LGE in patients with ApHCM. However, in patients with non-ApHCM, GLS was the strongest predictor of LGE (AUC = 0.91), with a −17% cutoff yielding 81% sensitivity and 80% specificity.
Myocardial work indices are significantly impaired in patients with ApHCM compared to those with non-ApHCM and correlate with important clinical variables. Global longitudinal strain, GWI, and GCW are more strongly predictive of fibrosis in patients with non-ApHCM than ApHCM.
•Myocardial work is a novel transthoracic echo method to evaluate LV performance.•Forty-eight patients with ApHCM were assessed.•Those with ApHCM had impaired work indices compared with non-ApHCM.•Work indices were associated with important clinical and imaging variables.•GLS was a strong predictor of fibrosis in non-ApHCM.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>37406714</pmid><doi>10.1016/j.echo.2023.06.013</doi><orcidid>https://orcid.org/0000-0002-4784-1275</orcidid></addata></record> |
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| subjects | Apical aneurysm Apical hypertrophic cardiomyopathy Cardiac magnetic resonance imaging Echocardiography Myocardial work |
| title | Myocardial Work in Apical Hypertrophic Cardiomyopathy |
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