Global longitudinal and circumferential strain, rotation, twist and untwist of the left ventricle in patients with asymmetric left ventricular hypertrophy

The aim of the study was to assess left ventricular (LV) global longitudinal Strain/Strain rate, global circumferential Strain/ Strain rate, rotation, twist and untwist in patients with asymmetric LV hypertrophy (LVH) who had gradient of obstruction in the LV outflow tract of 50 mm Hg and more. Thirty one patients with asymmetric LVH and gradient obstruction in the LV outflow were included in the study: 11 patients had arterial hypertension (AH) and 21 patients had normal range of blood pressure values. Criteria for inclusion in this study were gradient of obstruction in Lv outflow of 50 mm Hg and more, intraventricular septum (IVS) thickness of 13 mm and more, and parameters of IVS/LV posterior wall thickness ratio of 1.3 and more. Parameters of global longitudinal Strain/strain rate, global circumferential Strain/Strain rate, rotation, and LV twist were estimated as indicators of the LV systolic function. Left ventricular global longitudinal Strain was significantly lower in patients with AH in comparison with patients with normal range of blood pressures (12.317+2.175% vs. -15.891+5.145%, р=0.04). Left ventricular rotation at the level of basal segments was significantly increased in AH patients (11.164+3.938° vs. -5.915+3.492°, р=0.01) compared with patients with normal blood pressure; rotations at the levels of apex and papillary muscles did not differ between patients’ groups. Twist rate was higher in AH patients (129.302+24.973°/с -1 vs. 76.836+22.830°/с -1, р=0.008). In summary, patients with asymmetrical LVH and AH had lower global Strain as compared with patients with normal blood pressure whereas the LV rotation rate and twist at the level basal segments were higher in these patients.