[Real-time three-dimensional echocardiographic assessment of left ventricular diastolic dyssynchrony and dysfunction in hypertrophic cardiomyopathy].

Objective To assess left ventricular(LV) regional diastolic function in patients with hypertrophic cardiomyopathy(HCM) using single-beat real-time three-dimensional echocardiography(RT-3DE).Methods Sixty-nine patients with HCM(LV ejection fraction≥45%) and 50 normal control subjects underwent examinations by two-dimensional echocardiography(2DE) and RT-3DE.The parameters analyzed by RT-3DE included the end diastolic sphericity index(EDSI),diastolic dyssynchrony index(DDI),dispersion end diastole [DISPED,including late(DDI-late) and early(DDI-early) diastole,dispersion end diastole(DISPED-late),and dispersion early diastole(DISPED-early)].The patients were divided into 3 groups with impaired relaxation(n=23),pseudonormal filling(n=37),and restrictive filling(n=9).Results DDI and DISPED increased with the severity of diastolic dysfunction.In end diastole,DDI-late and DISPED-late were abnormal in cases with severe diastolic dysfunction(7.95±2.75 and 26.76±17.19,respectively,P0.0001) but normal in cases with mild diastolic dysfunction.In early diastole,DDI-early and DISPED-early both increased in cases of mild(8.57±2.24 and 25.44±6.31,respectively,P0.0001) and moderate(9.56 ± 4.66 and 35.42 ± 14.19,respectively,P0.0001) diastolic dysfunction.Conclusion In patients with HCM, dyssynchrony in early diastole is more obvious than that in late diastole and shows also a stronger correlation with diastolic dysfunction.This preclinical lesion can be detected by single-beat RT-3DE.