Usefulness of longitudinal strain adjusted to regional thickness in hypertrophic cardiomyopathy

Background In hypertrophic cardiomyopathy (HCM), longitudinal strain analysis allows to early detect left ventricular (LV) contraction abnormalities despite preserved LV ejection fraction. In current software, the width of the region of interest (ROI) is the same over the entire myocardial wall and might analyze partially LV hypertrophic segments. Purpose The aim of this study is to evaluate a novel software for strain analysis with an adjustable ROI according to each segment thickness. Methods We included 110 patients: 55 patients with HCM (HCM group) and 55 healthy subjects (age- and sex-matched control group). All pts underwent echocardiography using a Vivid 9 GE system and measurements were performed using EchoPAC software. Global longitudinal strain (GLS) and regional strain for each of the 17 segments were calculated with standard software (for 2 groups) and with software adjusted to the myocardial wall thickness (for HCM group). Results GLS was significantly decreased in the HCM group as compared to the control group (−15.1 ± 4.8% versus–20.5 ± 4.3%, P P  = 0.34). Interestingly, regional strain adjusted to thickness was significantly lower than standard strain in hypertrophic segments, especially in basal inferoseptal segment ( P  = 0.0002), median inferoseptal segment ( P  P  = 0.02). Strain adjusted to thickness was still significantly lower in the most hypertrophic segments (≥ 20 mm) (−3.7 ± 3%, versus −5.9 ± 4.4%, P P P  = 0.01). Conclusion Analysis of longitudinal strain adjusted to regional thickness is feasible in HCM and allows a better evaluation of myocardial deformation, especially in the most LV hypertrophic segments.