Global longitudinal strain of the left ventricle of the heart in patients with both hypertrophic cardiomyopathy and stenotic lesion of the coronary arteries

Research objective: to evaluate global longitudinal strain of the left ventricle in patients with hypertrophic cardiomyopathy (HCM) with different locations of myocardial thickening, with and without concomitant stenotic lesion of the coronary arteries. Materials and methods. Clinical data, echocardiography with speckle tracking echnology, and coronary angiography data from 69 patients with HCM aged 27 to 91 years were analysed. The optimal quantitative threshold for global longitudinal strain was determined by ROC analysis. Results. Echocardiography revealed septal HCM in 26 (37.7%) patients; symmetrical HCM in 18 (26.1%); combined variant in 14 (20.3%); apical variant in 9 (13%); and mid-ventricular variant in 2 (2.9%). Coronary angiography revealed stenotic lesions of the coronary arteries in 32 (46.4%) individuals with HCM. Global longitudinal strain in patients with HCM and concomitant stenotic lesion of the coronary arteries was > −11.2% (AUC 0.839). The degree of reduction in the indicator depended on the location of left ventricular thickening (AUC 0.867÷1). Obesity and reduced left ventricular ejection fraction in HCM reduced global longitudinal strain to > −8.5% (AUC 0.789) and > −7.4% (AUC 0.983), respectively. Conclusion. A decrease in global longitudinal strain of the left ventricle in patients with HCM suggests concomitant stenotic lesion of the coronary arteries: in the septal variant > −12.9%; symmetrical > −11.1%; apical > −10.2%. However, in each individual case, factors affecting global longitudinal strain of the left ventricle regardless of stenotic lesion of the coronary arteries should be taken into account: obesity and decreased left ventricular ejection fraction.