Tissue tracking of segmental strain as a predictor of provoked dynamic left ventricular outflow tract obstruction

Faculty Medicine Year: 2022
Type of Publication: ZU Hosted Pages: Pages: 414-419
Authors:
Journal: Indian Heart Journal Elsevier, a division of RELX India, Pvt. Ltd. Volume: 74
Keywords : Tissue tracking , segmental strain , , predictor , provoked    
Abstract:
Background Left ventricular outflow tract obstruction (LVOTO) is commonly observed in patients with hypertrophic cardiomyopathy (HCM) or left ventricular hypertrophy (LVH). Some patients develop LVOTO provoked by physical exertion, and hence termed dynamic LVOTO (DLVOTO). However, its precise prevalence and mechanism are still unclear. Aim Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful for the detection of early LV structural abnormalities. This study aimed to examine the possible role of segmental as well as global longitudinal strain in identifying DLVOTO non-HCM patients as detected by dobutamine stress echocardiography (DSE). Methods and results Two hundred and fifty patients without structural heart disease had undergone conventional transthoracic echocardiography, 2D STE, and DSE. All patients with non-ischemic evidence were divided into two groups according to the DSE results; DLVOTO (+) and DLVOTO (−). Among 250 patients, 50 patients (36%) had shown DLVOTO after DSE (15 males, 35 females; mean age 55±7years). They were compared with 90 non -LVOTO obstruction patients (43 males, 47 females; mean age 57±6years). Based on multivariate logistic regression analysis, the independent predictors of provoked DLVOTO during DSE were resting basal septal longitudinal strain BS-LS average (p < 0.001), resting LA reservoir strain (p < 0.001), and systolic LVOT diameter (p = 0.03). Resting BS-LS average with cut-off - 17.5% was recognized as a critical indicator of DLVOTO, with sensitivity 78%, and specificity 95% (better than systolic LVOT diameter of sensitivity 76%, and specificity 15% and resting LA reservoir strain which showed poor AUC at ROC curve 0.007). Conclusion We demonstrate that provoked LVOTO during DSE in non HCM symptomatic patients is directly correlated to resting regional LS, where the increased BS-LS of ≥ −17.5% was a key determinant of LVOT gradient provocation. Assessment of baseline BS-LS average might be a bedside simple tool for detection of patients with DLVOTO not able to do DSE.
   
     
 
       

Author Related Publications

  • Eslam Alsayed Mohamed Mohamed Shehata, "Resting Left Ventricular Systolic Dyssynchrony and Mechanical Reserve in Asymptomatic Normotensive Subjects with Early Type 2 Diabetes Mellitus", Karger, 2020 More
  • Eslam Alsayed Mohamed Mohamed Shehata, "Mitral annulus time intervals for assessment of left ventricular systolic function in ischemic cardiomyopathy", European Journal of Heart Failure Supplements (2012) 11, S128–S177, 2012 More
  • Eslam Alsayed Mohamed Mohamed Shehata, "Mitral annulus time intervals for assessment of left ventricular systolic function in dilated cardiomyopathy", European Journal of Heart Failure Supplements (2012) 11, S128–S177, 2012 More
  • Eslam Alsayed Mohamed Mohamed Shehata, "Comparison between drug-coated balloon angioplasty and second-generation drugeluting stent placement for the treatment of in-stent restenosis after drug-eluting stent implantation", Springer, 2016 More
  • Eslam Alsayed Mohamed Mohamed Shehata, "Coronary slow flow and its correlation with reduced left ventricle global longitudinal strain: a case–control study", Springer Nature, 2024 More

Department Related Publications

  • Mohammed Ibrahim Amin Ibrahim Musa, "HbA1c And Insulin Resistance As Predictors For The Severity Of Coronary Artery Disease And Systolic Heart Failure In Non Diabetic Patients.", مجله كليه الطب البشري - جامغه الزقازيق, 2014 More
  • Muntasir Mustafa Ahmad, "قيمة الاجابة مضيق الشرايين التاجيين كمؤشر لضيق الشريان الكلوي", لايوجد, 1900 More
  • Muntasir Mustafa Ahmad, "قيمة سملة البطتنة والقيمة الوسطي للشرايين كعامل غير نافذ للتنبؤ بمرض الشريان التاجي", لايوجد, 1900 More
  • Muntasir Mustafa Ahmad, "المسافة بين نقطة التقاء وريقات الصمام الميترالي ومستواة الحلقي كمؤشر ", لايوجد, 1900 More
  • Muntasir Mustafa Ahmad, "قياس حركة ومسدحة الحلقة الشرفية الثلاثية كوسيلة لتنظيم وظيفة القلب ", لايوجد, 1900 More
Tweet