Open Access

Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects

  • Authors:
    • Yuan Cao
    • Xiao‑Yan Sun
    • Ming Zhong
    • Li Li
    • Mei Zhang
    • Ming‑Jie Lin
    • Yu‑Ke Zhang
    • Gui‑Hua Jiang
    • Wei Zhang
    • Yuan‑Yuan Shang
  • View Affiliations

  • Published online on: April 19, 2019     https://doi.org/10.3892/etm.2019.7507
  • Pages: 4379-4388
  • Copyright: © Cao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )
Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )


Abstract

The present study investigated the role of energy loss assessed by vector flow mapping (VFM) in patients with hypertrophic cardiomyopathy (HCM). VFM analysis was performed in 42 patients with HCM and in 40 control subjects, which were matched for age, sex and left ventricular (LV) ejection fraction. The intra‑LV and left atrial blood flow were obtained from the apical 3‑chamber view, and the energy loss (EL) during the systolic and diastolic phases was calculated. The measurements were averaged over three cardiac cycles and indexed to body surface area. Compared with the controls, the left ventricular energy loss (LVEL)‑total value was significantly decreased in patients with HCM during the diastolic phase (P1, P2 and P3; all P<0.05). A tendency for increased systolic LVEL‑total values was observed in the patients with HCM compared with the controls (P>0.05). LVEL‑base values were decreased in the patients with HCM during P1 and P2 (slow filling time). Compared with the controls, patients with HCM had lower LVEL‑mid values during the diastolic phases (P0, P1, P2 and P3; all P<0.05). However, the LVEL‑mid value of patients with HCM was higher compared with that of the controls during systolic P5 (P<0.05). LVEL‑apex was decreased in patients with HCM during P0, P2 and P3. Compared with the controls, the left atrial energy loss (LAEL) of all three phases in patients with HCM were lower (each P<0.01). The diastolic LVEL values were significantly lower in patients with HCM compared with the controls; however, the systolic LVEL levels tended to be higher in HCM. The LAEL of the reservoir phase, conduit phase and atrial systolic phase were decreased in HCM compared with controls. The present study demonstrated that measurement of EL by VFM is a sensitive method of determining subclinical LV dysfunction in patients with HCM. The value of EL has been considered to be a quantitative parameter for the estimation of the efficiency of intraventricular blood flow.

References

1 

Ingles J, Burns C, Bagnall RD, Lam L, Yeates L, Sarina T, Puranik R, Briffa T, Atherton JJ, Driscoll T and Semsarian C: Nonfamilial hypertrophic cardiomyopathy: Prevalence, natural history, and clinical implications. Circ Cardiovasc Genet. 10(pii): e0016202017.PubMed/NCBI

2 

Jacoby DL, DePasquale EC and McKenna WJ: Hypertrophic cardiomyopathy: Diagnosis, risk stratification and treatment. CMAJ. 185:127–134. 2013. View Article : Google Scholar : PubMed/NCBI

3 

Houston BA and Stevens GR: Hypertrophic cardiomyopathy: A review. Clin Med Insights Cardiol. 8 (Suppl 1):S53–S65. 2015.

4 

Authors/Task Force members, ; Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, et al: 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: The Task Force for the diagnosis and management of hypertrophic cardiomyopathy of the European society of cardiology (ESC). Eur Heart J. 35:2733–2779. 2014. View Article : Google Scholar : PubMed/NCBI

5 

Voilliot D, Huttin O, Hammache N, Filippetti L, Vaugrenard T, Aliot E, Sadoul N, Juillière Y and Selton-Suty C: Impact of Global and segmental hypertrophy on two-dimensional strain derived from three-dimensional echocardiography in hypertrophic cardiomyopathy: Comparison with healthy subjects. J Am Soc Echocardiogr. 28:1093–1102. 2015. View Article : Google Scholar : PubMed/NCBI

6 

Maron BJ and Maron MS: Hypertrophic cardiomyopathy. Lancet (London, England). 381:242–255. 2013. View Article : Google Scholar : PubMed/NCBI

7 

Kalra A, Harris KM, Maron BA, Maron MS, Garberich RF, Haas TS, Lesser JR and Maron BJ: Relation of Doppler tissue imaging parameters with heart failure progression in hypertrophic cardiomyopathy. Am J Cardiol. 117:1808–1814. 2016. View Article : Google Scholar : PubMed/NCBI

8 

Saccheri MC, Cianciulli TF, Lax JA, Guerra JE, Redruello HJ, Weich Glogier FL, Gagliardi JA, Dorelle AN, Prezioso HA and Vidal LA: Impaired myocardial function in hypertrophic cardiomyopathy. Echocardiography. 26:657–664. 2009. View Article : Google Scholar : PubMed/NCBI

9 

MacIver DH and Clark AL: Contractile dysfunction in sarcomeric hypertrophic cardiomyopathy. J Card Fail. 22:731–737. 2016. View Article : Google Scholar : PubMed/NCBI

10 

Hayashi T, Itatani K, Inuzuka R, Shimizu N, Shindo T, Hirata Y and Miyaji K: Dissipative energy loss within the left ventricle detected by vector flow mapping in children: Normal values and effects of age and heart rate. J Cardiol. 66:403–410. 2015. View Article : Google Scholar : PubMed/NCBI

11 

Kurt M, Wang J, Torre-Amione G and Nagueh SF: Left atrial function in diastolic heart failure. Circ Cardiovasc Imaging. 2:10–15. 2009. View Article : Google Scholar : PubMed/NCBI

12 

Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, et al: 2013 ESH/ESC guidelines for the management of arterial hypertension: The Task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC). Eur Heart J. 34:2159–2219. 2013. View Article : Google Scholar : PubMed/NCBI

13 

Cameli M, Mandoli GE and Mondillo S: Left atrium: The last bulwark before overt heart failure. Heart Fail Rev. 22:123–131. 2017. View Article : Google Scholar : PubMed/NCBI

14 

Cameli M, Ciccone MM, Maiello M, Modesti PA, Muiesan ML, Scicchitano P, Novo S, Palmiero P, Saba PS and Pedrinelli R; Gruppo di Studio Ipertensione, Prevenzione e Riabilitazione, Società Italiana di Cardiologia, : Speckle tracking analysis: A new tool for left atrial function analysis in systemic hypertension: An overview. J Cardiovasc Med (Hagerstown). 17:339–343. 2016. View Article : Google Scholar : PubMed/NCBI

15 

Xu HY, Chen J, Yang ZG, Li R, Shi K, Zhang Q, Liu X, Xie LJ, Jiang L and Guo YK: Early marker of regional left ventricular deformation in patients with hypertrophic cardiomyopathy evaluated by MRI tissue tracking: The effects of myocardial hypertrophy and fibrosis. J Magn Reson Imaging. 46:1368–1376. 2017. View Article : Google Scholar : PubMed/NCBI

16 

Ozawa K, Funabashi N, Takaoka H, Kamata T, Kanaeda A, Saito M, Nomura F and Kobayashi Y: Characteristic myocardial strain identified in hypertrophic cardiomyopathy subjects with preserved left ventricular ejection fraction using a novel multi-layer transthoracic echocardiography technique. Int J Cardiol. 184:237–243. 2015. View Article : Google Scholar : PubMed/NCBI

17 

Kato TS, Noda A, Izawa H, Yamada A, Obata K, Nagata K, Iwase M, Murohara T and Yokota M: Discrimination of nonobstructive hypertrophic cardiomyopathy from hypertensive left ventricular hypertrophy on the basis of strain rate imaging by tissue Doppler ultrasonography. Circulation. 110:3808–3814. 2004. View Article : Google Scholar : PubMed/NCBI

18 

Oki T, Mishiro Y, Yamada H, Onose Y, Matsuoka M, Wakatsuki T, Tabata T and Ito S: Detection of left ventricular regional relaxation abnormalities and asynchrony in patients with hypertrophic cardiomyopathy with the use of tissue Doppler imaging. Am Heart J. 139:497–502. 2000. View Article : Google Scholar : PubMed/NCBI

19 

Amundsen BH, Helle-Valle T, Edvardsen T, Torp H, Crosby J, Lyseggen E, Støylen A, Ihlen H, Lima JA, Smiseth OA and Slørdahl SA: Noninvasive myocardial strain measurement by speckle tracking echocardiography: Validation against sonomicrometry and tagged magnetic resonance imaging. J Am Coll Cardiol. 47:789–793. 2006. View Article : Google Scholar : PubMed/NCBI

20 

Cameli M, Mandoli GE, Loiacono F, Dini FL, Henein M and Mondillo S: Left atrial strain: A new parameter for assessment of left ventricular filling pressure. Heart Fail Rev. 21:65–76. 2016. View Article : Google Scholar : PubMed/NCBI

21 

Stugaard M, Koriyama H, Katsuki K, Masuda K, Asanuma T, Takeda Y, Sakata Y, Itatani K and Nakatani S: Energy loss in the left ventricle obtained by vector flow mapping as a new quantitative measure of severity of aortic regurgitation: A combined experimental and clinical study. Eur Heart J Cardiovasc Imaging. 16:723–730. 2015. View Article : Google Scholar : PubMed/NCBI

22 

Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R and Lafitte S: Global and regional myocardial function quantification by two-dimensional strain: Application in hypertrophic cardiomyopathy. J Am Coll Cardiol. 47:1175–1181. 2006. View Article : Google Scholar : PubMed/NCBI

23 

Urbano-Moral JA, Rowin EJ, Maron MS, Crean A and Pandian NG: Investigation of global and regional myocardial mechanics with 3-dimensional speckle tracking echocardiography and relations to hypertrophy and fibrosis in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging. 7:11–19. 2014. View Article : Google Scholar : PubMed/NCBI

24 

Maron BJ, Spirito P, Green KJ, Wesley YE, Bonow RO and Arce J: Noninvasive assessment of left ventricular diastolic function by pulsed Doppler echocardiography in patients with hypertrophic cardiomyopathy. J Am Coll Cardiol. 10:733–742. 1987. View Article : Google Scholar : PubMed/NCBI

25 

Liu W, Sun D and Yang J: Diastolic dysfunction of hypertrophic cardiomyopathy genotype-positive subjects without hypertrophy is detected by tissue Doppler imaging: A systematic review and Meta-analysis. J Ultrasound Med. 36:2093–2103. 2017. View Article : Google Scholar : PubMed/NCBI

26 

Ho CY: Hypertrophic cardiomyopathy: Preclinical and early phenotype. J Cardiovasc Transl Res. 2:462–470. 2009. View Article : Google Scholar : PubMed/NCBI

27 

Pedrizzetti G, La Canna G, Alfieri O and Tonti G: The vortex-an early predictor of cardiovascular outcome? Nat Rev Cardiol. 11:545–553. 2014. View Article : Google Scholar : PubMed/NCBI

28 

Kilner PJ, Yang GZ, Wilkes AJ, Mohiaddin RH, Firmin DN and Yacoub MH: Asymmetric redirection of flow through the heart. Nature. 404:759–761. 2000. View Article : Google Scholar : PubMed/NCBI

29 

Gharib M, Rambod E, Kheradvar A, Sahn DJ and Dabiri JO: Optimal vortex formation as an index of cardiac health. Proc Natl Acad Sci USA. 103:6305–6308. 2006. View Article : Google Scholar : PubMed/NCBI

30 

Borazjani I, Westerdale J, McMahon EM, Rajaraman PK, Heys JJ and Belohlavek M: Left ventricular flow analysis: Recent advances in numerical methods and applications in cardiac ultrasound. Comput Math Methods Med. 2013:3950812013. View Article : Google Scholar : PubMed/NCBI

31 

Abe H, Caracciolo G, Kheradvar A, Pedrizzetti G, Khandheria BK, Narula J and Sengupta PP: Contrast echocardiography for assessing left ventricular vortex strength in heart failure: A prospective cohort study. Eur Heart J Cardiovasc Imaging. 14:1049–1060. 2013. View Article : Google Scholar : PubMed/NCBI

32 

Maron BJ: Hypertrophic cardiomyopathy: A systematic review. JAMA. 287:1308–1320. 2002. View Article : Google Scholar : PubMed/NCBI

33 

Butz T, van Buuren F, Mellwig KP, Langer C, Plehn G, Meissner A, Trappe HJ, Horstkotte D and Faber L: Two-dimensional strain analysis of the global and regional myocardial function for the differentiation of pathologic and physiologic left ventricular hypertrophy: A study in athletes and in patients with hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 27:91–100. 2011. View Article : Google Scholar : PubMed/NCBI

34 

Aly MF, Brouwer WP, Kleijn SA, van Rossum AC and Kamp O: Three-dimensional speckle tracking echocardiography for the preclinical diagnosis of hypertrophic cardiomyopathy. Int J Cardiovasc Imaging. 30:523–533. 2014. View Article : Google Scholar : PubMed/NCBI

35 

Cameli M, Sparla S, Losito M, Righini FM, Menci D, Lisi M, D'Ascenzi F, Focardi M, Favilli R, Pierli C, et al: Correlation of left atrial strain and Doppler measurements with invasive measurement of left ventricular End-diastolic pressure in patients stratified for different values of ejection fraction. Echocardiography. 33:398–405. 2016. View Article : Google Scholar : PubMed/NCBI

36 

Lakatta EG and Levy D: Arterial and cardiac aging: Major shareholders in cardiovascular disease enterprises: Part II: The aging heart in health: links to heart disease. Circulation. 107:346–354. 2003. View Article : Google Scholar : PubMed/NCBI

37 

Cameli M, Mandoli GE, Loiacono F, Sparla S, Iardino E and Mondillo S: Left atrial strain: A useful index in atrial fibrillation. Int J Cardiol. 220:208–213. 2016. View Article : Google Scholar : PubMed/NCBI

38 

Paraskevaidis IA, Panou F, Papadopoulos C, Farmakis D, Parissis J, Ikonomidis I, Rigopoulos A, Iliodromitis EK and Th Kremastinos D: Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: A tissue Doppler imaging and two-dimensional strain study. Heart. 95:483–489. 2009. View Article : Google Scholar : PubMed/NCBI

39 

Pavlopoulos H and Nihoyannopoulos P: Left atrial size: A structural expression of abnormal left ventricular segmental relaxation evaluated by strain echocardiography. Eur J Echocardiogr. 10:865–871. 2009. View Article : Google Scholar : PubMed/NCBI

40 

Wang Y, Hou D, Ma R, Ding G, Yin L and Zhang M: Early detection of left atrial energy loss and mechanics abnormalities in diabetic patients with normal left atrial size: A study combining vector flow mapping and tissue tracking echocardiography. Med Sci Monit. 22:958–968. 2016. View Article : Google Scholar : PubMed/NCBI

Related Articles

Journal Cover

June 2019
Volume 17 Issue 6

Print ISSN: 1792-0981
Online ISSN:1792-1015

Sign up for eToc alerts

Recommend to Library

Copy and paste a formatted citation
APA
Cao, Y., Sun, X., Zhong, M., Li, L., Zhang, M., Lin, M. ... Shang, Y. (2019). Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects. Experimental and Therapeutic Medicine, 17, 4379-4388. https://doi.org/10.3892/etm.2019.7507
MLA
Cao, Y., Sun, X., Zhong, M., Li, L., Zhang, M., Lin, M., Zhang, Y., Jiang, G., Zhang, W., Shang, Y."Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects". Experimental and Therapeutic Medicine 17.6 (2019): 4379-4388.
Chicago
Cao, Y., Sun, X., Zhong, M., Li, L., Zhang, M., Lin, M., Zhang, Y., Jiang, G., Zhang, W., Shang, Y."Evaluation of hemodynamics in patients with hypertrophic cardiomyopathy by vector flow mapping: Comparison with healthy subjects". Experimental and Therapeutic Medicine 17, no. 6 (2019): 4379-4388. https://doi.org/10.3892/etm.2019.7507