Evaluation of left ventricular systolic function reserve in patients with non-obstructive hypertrophic cardiomyopathy using myocardial work combined with exercise stress echocardiography
YE Teng, LI Hui, JIA Zhijun, LIAO Shusheng.
Department of Ultrasound, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China
YE Teng,LI Hui,JIA Zhijun, et al. Evaluation of left ventricular systolic function reserve in patients with non-obstructive hypertrophic cardiomyopathy using myocardial work combined with exercise stress echocardiography[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(10): 798-805.
Abstract：Objective: To quantitatively evaluate the changes of left ventricular myocardial work before and after Squatting-Rising loading test in patients with non-obstructive hypertrophic cardiomyopathy (NHCM) by using noninvasive left ventricular pressure-strain loop (LVPSL), providing reference for clinical evaluation of left ventricular contractile reserve function, and individualized exercise guidance. Methods: A prospective analysis was made of 37 non-obstructive hypertrophic cardiomyopathy patients diagnosed by echocardiography in the First Affiliated Hospital of Wenzhou Medical University from January 2022 to December 2023. LVGLS and myocardial work parameters were estimated before and after Squatting-Rising loading test, and the relationship between LVGLS and myocardial work parameters was analyzed. Results: During the afterload-elevation,systolic blood pressure increased by (18±13) mmHg (P<0.01), followed by a slight increase in LVEF from (65.09%±4.91%) to (66.01%±4.92%) (P>0.05). There was a significant increase in LVGLS, GCW and GWW following the loading test (P<0.05). However, there were no significant differences in GWI and GWE before and after loading test. Furthermore, LVGLS was positively correlated with GWI, GCW, and GWE (P<0.05), while negatively correlated with GWW (P<0.05) during rest. After loading text, LVGLS was positively correlated with GWI, GCW, and GWE (P<0.05), but not correlated with GWW. The repeatability of myocardial work parameters was better in both groups. Conclusion: This study demonstrated that a modest increase in afterload can result in slight increase in LVGLS and significant increase in GCW, LVPSL combined with exercise stress echocardiography provides a more sensitive assessment on the measurement of myocardial reserve in NHCM patients.
