1. Echocardiographic Strain Abnormalities Precede Left Ventricular Hypertrophy Development in Hypertrophic Cardiomyopathy Mutation Carriers.
- Author
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Canciello G, Lombardi R, Borrelli F, Ordine L, Chen SN, Santoro C, Frisso G, di Napoli S, Polizzi R, Cristiano S, Esposito G, and Losi MA
- Subjects
- Humans, Male, Female, Adult, Middle Aged, Adolescent, Myosin Heavy Chains genetics, Troponin T genetics, Heterozygote, Carrier Proteins genetics, Young Adult, Phenotype, Cardiac Myosins genetics, Echocardiography methods, Hypertrophy, Left Ventricular genetics, Hypertrophy, Left Ventricular diagnostic imaging, Hypertrophy, Left Ventricular etiology, Mutation, Cardiomyopathy, Hypertrophic genetics, Cardiomyopathy, Hypertrophic diagnostic imaging
- Abstract
Hypertrophic cardiomyopathy (HCM) is a genetic disease characterized by unexplained left ventricular hypertrophy (LVH), diastolic dysfunction, and increased sudden-death risk. Early detection of the phenotypic expression of the disease in genetic carriers without LVH (Gen+/Phen-) is crucial for emerging therapies. This clinical study aims to identify echocardiographic predictors of phenotypic development in Gen+/Phen-. Sixteen Gen+/Phen- (one subject with troponin T, six with myosin heavy chain-7, and nine with myosin-binding protein C3 mutations), represented the study population. At first and last visit we performed comprehensive 2D speckle-tracking strain echocardiography. During a follow-up of 8 ± 5 years, five carriers developed LVH (LVH+). At baseline, these patients were older than those who did not develop LVH (LVH-) (30 ± 8 vs. 15 ± 8 years, p = 0.005). LVH+ had reduced peak global strain rate during the isovolumic relaxation period (SRIVR) (0.28 ± 0.05 vs. 0.40 ± 0.11 1/s, p = 0.048) and lower global longitudinal strain (GLS) (-19.8 ± 0.4 vs. -22.3 ± 1.1%; p < 0.0001) than LVH- at baseline. SRIVR and GLS were not correlated with age (overall, p > 0.08). This is the first HCM study investigating subjects before they manifest clinically significant or relevant disease burden or symptomatology, comparing at baseline HCM Gen+/Phen- subjects who will develop LVH with those who will not. Furthermore, we identified highly sensitive, easily obtainable, age- and load-independent echocardiographic predictors of phenotype development in HCM gene carriers who may undergo early preventive treatment.
- Published
- 2024
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