Evaluation of the prognostic value of papillary muscle‐free strain in patients with hypertrophic cardiomyopathy

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 41; no. 7; pp. e15882 - n/a
• Main Authors: Koyuncu, Atilla, Yildiz, Cennet, Oflar, Ersan, Mavi, Busra, Ertugrul, Abdulcelil Sait, Ocal, Lutfi, Gürsoy, Mustafa Ozan, Kahveci, Gokhan
• Format: Journal Article
• Language: English
• Published: United States 01.07.2024
• Subjects: cardiomyopathy; Cardiomyopathy, Hypertrophic - complications; Cardiomyopathy, Hypertrophic - physiopathology; Echocardiography - methods; Female; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; hypertrophic; Male; Middle Aged; papillary muscle; Papillary Muscles - diagnostic imaging; Papillary Muscles - physiopathology; Prognosis; Reproducibility of Results; strain imaging; hypertrophic; papillary muscle; strain imaging; cardiomyopathy
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/echo.15882

Background The prognosis of hypertrophic cardiomyopathy (HCM) varies from mild disease with a normal life expectancy to heart failure and sudden cardiac death (SCD). The identification of patients who are at high risk for SCD remains challenging. Aims In this study, we evaluated the prognostic value of papillary muscle‐free strain in HCM patients. Methods and Results Seventy‐nine patients with a diagnosis of HCM were included in this study. Patients were divided into low/intermediate‐risk (n = 57) and high‐risk (n = 22) groups. Two‐dimensional (2‐D) echocardiography and strain imaging were performed for each patient. The mean age of the study population was 53.85 ± 15.88 years; 47 (59.5%) of them were male. During a mean follow‐up duration of 74.45 ± 17.03 months, 12 patients died. A comparison of the low‐intermediate and high‐SCD risk groups revealed that patients in the high‐SCD risk group had greater maximal wall thickness, interventricular septum thickness, posterior wall thickness, and left ventricular mass index (LVMI) and lower (less negative) global longitudinal, anterolateral papillary muscle (ALPM) and posteromedial papillary muscle (PMPM) free strain. Additionally, a history of syncope and ICD implantation were found to be more common in patients with high SCD risk scores. The SCD risk score was positively correlated with the global longitudinal strain, ALPM‐free strain, and PMPM‐free strain (r = .528, r = .658, and r = .600, respectively; p < .001 for all). Our results showed that the LVMI, presence of syncope, global longitudinal strain, and ALPM‐free strain were predictors of death. Conclusions Decreased papillary muscle‐free strain values might have prognostic value in patients with HCM. Graphical s show that among clinical and echocardiographic parameters only left ventricular mass index, presence of syncope, GLS, and ALPM‐free strain were the predictors of death.