Clinical Research On Ventricular-arterial Coupling Relationship In Patients With Hypertrophic Cardiomyopathy By Echocardiography

Objectives:?1?The change of ascending aortic?AAO?elasticity is an important factor in the development of cardiovascular diseases.The AAO elastic characteristics were evaluated by echocardiography in this study,in order to investigate AAO biomechanical function changes in patients with hypertrophic cardiomyopathy?HCM?.?2?Ventricular-arterial coupling?VAC?may be used to reflect the nature of cardiovascular changes and predict the occurrence of adverse cardiovascular events.In this study,left ventricular function was evaluated by strain and strain rate imaging?S/SRI?,and the VAC relationship was explored,in order to insight into the pathophysiological changes of HCM and provide valuable information for clinical diagnosis and treatment.Methods:Totally 30 HCM patients were enrolled,including 14hypertrophic obstructive cardiomyopathy patients and 16 hypertrophic non-obstructive cardiomyopathy patients.27 cases were set as normal control group.?1?The end-systolic and end-diastolic AAO diameters were measured by M-mode echocardiography.The brachial blood pressure was recorded.AAO strain,distensibility,and stiffness index were calculated.The systolic,early-diastolic and late-diastolic velocities of AAO anterior wall were measured by tissue Doppler imaging.The differences of parameters between the two groups were compared.?2?The left ventricular segmental longitudinal strain and strain rate?S/SR?parameters were measured by S/SRI,including peak systolic strain(?_sys),peak systolic strain rate(SR_sys),peak early diastolic strain rate?SR_e?,and peak atrial diastolic strain rate?SR_a?.The left ventricular global longitudinal S/SR parameters were also measured,including peak systolic strain(G?_sys),peak systolic strain rate(GSR_sys),peak early diastolic strain rate?GSR_e?,and peak atrial diastolic strain rate?GSR_a?.The differences of S/SR parameters between the HCM group and normal control group were compared.The correlations between the AAO elastic parameters and left ventricular S/SR parameters(G?_sys?GSR_sys?GSR_e)were analysed.Results:?1?AAO strain and distensibility were significantly lower in HCM group than in control group?all P<0.01?,while the stiffness index was significantly higher in HCM group than in control group?P<0.01?.The early-diastolic and late-diastolic velocities of AAO anterior wall were significantly lower in HCM group than in control group?all P<0.01?,and the systolic velocity was lower in HCM group than in control group?P<0.05?.?2?The left ventricular segmental longitudinal S/SR parameters(?_sys?SR_sys?SR_e?SR_a)and the global longitudinal S/SR parameters(G?_sys?GSR_sys?GSR_e?GSR_a)were significantly lower in HCM group than in control group?all P<0.01?.The AAO elastic parameters showed a significant correlation with left ventricular S/SR parameters(G?_sys?GSR_sys?GSR_e)?all P<0.05?.Conclusions:?1?The biomechanical function of AAO was impaired,which appeared as its elasticity and compliance decreased and stiffness increased.?2?S/SRI can be used to accurately and sensitively evaluate the left ventricular function in patients with HCM.The left ventricular longitudinal S/SR parameters decreased,and there was a coupling relationship between the cardiac and vascular function in patients with HCM.