Strain bidimensional longitudinal na cardiomiopatia hipertrófica com fraçao de ejeçao preservada

Introducao: A nova tecnologia do strain bidimensional (st2d) permite uma analise mais precisa da funcao global e segmentar do ventriculo esquerdo (VE), incluindo sua porcao apical, por ser ângulo-independente. Objetivo: Avaliar a funcao sistolica global do VE com o st-2d em pacientes (pcs) com Cardiomiopatia Hipertrofica (CMH). Metodos: Foram incluidos 21 pcs com CMH e fracao de ejecao do VE preservada (G-CMH), e 21 pcs sem CMH, compondo o grupo controle (G-nl). Foi mensurado o st-2d longitudinal endocardico global (st2D-L), pela tecnica optical flow, dos 18 segmentos do VE, a partir de 3 cortes apicais. Empregou-se o teste t de Student para analise de variaveis continuas, e o Qui-quadrado (Pearson) para variaveis nao continuas, considerando-se um nivel de significância de 0,05. Resultados: Nao foi observada diferenca entre os grupos quanto a idade, sexo e pressao arterial sistolica e diastolica e frequencia cardiaca. Dezesseis pcs do G-CMH apresentavam a forma assimetrica septal da hipertrofia, com envolvimento adicional ou nao de paredes adjacentes (G-CMHs), e cinco apresentavam a forma apical da CMH (G-CMHap). Apesar da fracao de ejecao do VE ser preservada nos 2 grupos, o st2D-L mostrou-se globalmente reduzido no G-CMH (14,6 + 4,3 vs 18,6 + 2,6% no G-C;p=0,009). No G-CMHs, notou-se valor significativamente menor do st2D-L em relacao ao G-nl (13,6 + 3,9 versus 18,5 + 2,5%; p Introduction: The recent developed technology of two-dimensional strain (st2D) allows a more precise analysis of global and segmental function of the left ventricle (LV), including the apical region, due to its angle-independence. Objective: The aim of the study was to evaluate global LV systolic function with st2D in patients (pts) with Hypertrophic Cardiomyopathy (HCM). Methods: We included 21 pts with HCM and preserved LV ejection fraction (G-HCM), and 21 control pcs (G-nl). The global endocardial longitudinal st2D (st2D-L) of 18 myocardial LV segments was measured, by using “optical flow” technology, from the 3 apical views. The Student “t” test was used for analysis of the continuous variables, and the “Chi-square” (Pearson) for the non-continuous variables, considering a significance level of 0,05. Results: No significant difference was observed between the groups regarding age, sex, systolic and diastolic blood pressure, and heart rate. Sixteen pts from the G-HCM presented septal asymmetric hypertrophy, with additional involvement of adjacent walls or not (G-HCMs), and five showed the apical form of HCM (G-HCMap). Although LV ejection fraction was preserved in both groups, the st2D-L was significantly reduced in the G-HCM (14,.1 + 4,3 vs 18,6 + 2,6% in G-nl, p = 0.009). In the G-HCMs the st2D-L was lower compared to G-nl (13,6 + 3.9 vs 18,5 + 2.5%, p