Huttin, O.

Selton-Suty, C.

Vaugrenard, T.

Voilliot, D.

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Poster session, Friday morning, 14 June 257
hypertrophic cardiomyopathy: A 3D speckle
tracking imaging study
D. Voilliot a, O. Huttina, T. Vaugrenardb, C. Selton-Sutya
a ILCV, CHU de Brabois, Nancy, France
b CHU de Marseille, Marseille, France
Objectives.— To assess LV myocardial deformation with 3D echocar-
diography in HCM and study the impact of hypertrophy on global
and regional systolic deformation.
Patients and methods.— A complete rest echocardiography (GE
Vivid 9) was performed in 41 HCM and in 114 control patients. Sec-
ondary HCM were excluded. LV systolic deformation was assessed
by 3D strains. Values of 3D global LV longitudinal (3DGLS), cir-
cumferential (3DGCS), radial (3DRS) and area strain (3DGAS) were
obtained from all patients. We classiﬁed segments depending on
their thickness as ﬁrst quartile (< 105mm, n = 157), second quartile
(105—131mm, n = 152), third quartile (131—166mm, n = 162) and
fourth quartile (> 166mm, n = 165).
Results.— All strain values were signiﬁcantly higher in control than
in HCM pts. There was a signiﬁcant decrease from second quartile
to fourth quartile (P < 0.05), gradually for longitudinal then radial
and circumferential strain values (Table 1).
Conclusion.— 3D echocardiography is a useful tool in HCM patients,
bringing in one acquisition all global and regional deformations
parameters.
Hypertrophy has an impact on the global mechanics of LV
and on regional kinetics of hypertrophic segment impairing
gradually longitudinal then circumferential and radial defor-
mation. However, there is also an impact on mechanics of
non-hypertrophic segments suggesting an overall involvement of the
myocardium.
Table 1 3D strain values.
<105mm
segments
n = 157
105—131mm
segments
n = 152
131—166mm
segments
n = 162
> 166mm
segments
n = 165
HCM patients
n = 41
Controls
subjects
n = 114
Age (years) 56.6± 1 13.5 54.9± 12.0
LVEF (%) 62.3± 7.1 62.6± 4.4
3D GAS (%) −29.4± 10.7 −27.3± 9.5a −23.5± 110.4b −20.5± 7.1c −25.0± 10d −34.8± 3.2
3DGLS (%) −14.6± 8.5 −12.6± 17.8a −9.8± 8.1b −7.5± 7.1c −11.2± 17.7d −20.3± 2.7
3DGCS (%) −18.6± 6.5 −17.9± 6.7a −16.2± 7.0b −14.8± 6.5c −16.8± 6.9d 18.7± 2.9
3DGRS (%) 47.31± 21.7 42.0± 19a 35.4± 19.5b 28.4± 14.9c 38.3± 20d 54.6± 9.0
a P < 0.05, 105—131 segments vs. 131—166mm segments.
b P < 0.05, 131—166mm segments vs. > 166mm segments.
c P < 0.05, 105—131 segments vs. > 166mm segments.
d P < 0.05, HCM patients vs. controls subjects.
http://dx.doi.org/10.1016/j.acvd.2013.03.032
30
Diagnostic value of three-dimensional
contrast-enhanced echocardiography for left
ventricular volume and ejection fraction
measurement in patients with poor acoustic
windows: An echo MRI comparison
E. Saloux , F. Labombarda , B. Anthune , A. Pellisier , A. Manrique
CHU de Caen, Caen, France
Objectives.— Three-dimensional echocardiography (3DE) led to sig-
niﬁcant improvement in the accuracy and reproducibility of left
ventricular volumes (LVV) and ejection fraction (EF) measurements
but remains sensitive to patient echogenicity. The aim of this study
was to evaluate the impact of temporal resolution, spatial reso-
lution and image dynamic range on the ability of 3-dimensional
contrast-enhanced echocardiography (C3DE) to assess LV function
compared to CMR.
Patients and methods.— We investigated 54 consecutive patients
referred to our institution who underwent LV function assess-
ment using both contrast echocardiography and cardiac magnetic
resonance imaging CMR. All patients underwent two-dimensional
echocardiography (2DE), non-contrast 3-dimensional echocardiog-
raphy (NC3DE) and contrast-enhanced (C3DE) and CMR. LVV and EF
were calculated for all modalities.
Results.— Left ventricular end-diastolic volume (EDV) was under-
estimated by 2DE (141.8± 58.3mL), 3DE (145.6± 68.6mL), and
to a lesser extent by C3DE (172.3± 72mL) compared to CMR
(216.1± 85.0mL, all P values < 0.001). Results were similar for cal-
culation of LVESV. C3DE provided the best agreement with CMR
with a greater Lin’s concordance correlation coefﬁcient of 0.67,
0.93 and 0.99 respectively for EDV, ESV and LVEF and less drift
of the bias for LVV and EF (lowest r2 coefﬁcient values between
the difference and the average of the measurement, respectively
r2 = 0.14, 0.18 and 0.01 for EDV, ESV and EF) as well as the
best measurement reproducibility. Finally, ultrasound settings (spa-
tial and temporal resolution, dynamic range) had no signiﬁcant
effect on volumes and ejection fraction measurements according
to MRI.
Conclusion.— C3DE overcomes 2DE and NC3DE and is a power-
ful alternative to CMR in patients with poor ultrasound image
quality. Furthermore, this study showed that the choice of ultra-
sound settings, despite a sharp deterioration in spatial and
temporal resolution, did not alter the accuracy of LV function
assessment.
http://dx.doi.org/10.1016/j.acvd.2013.03.033
31
Is there a cardiac involvement in patients with
hemoglobin sickle cell disease?
N. Hammoudi a, M. Dupreya, M. Djebbara, M. Charbonnierb,
K. Stojanovic c, R. Girot c, P.-L. Michel a, R. Isnarda, F. Lionnetc
a Hôpital de la Pitié-Salpêtrière, Paris, France
b Hôpital Saint-Antoine, Paris, France
c Hôpital Tenon, Paris, France
Background.— Adult’s patients with homozygous sickle cell disease
have usually a dramatic left ventricular enlargement and a cardiac
high output. Pulmonary hypertension is frequent in this population.
Hemoglobin sickle cell disease is currently considered to be a mild
variant of homozygous sickle cell disease with less severe anemia. At
date no study have been dedicated to describe cardiac involvement
of this disease.
Objective.— To investigate cardiac involvement in adults patients
with hemoglobin sickle cell disease (SC).
Methods.— Using a case-control design, 64 adults with SC in sta-
ble condition (mean age 33.1± 10.9 years, 34 women) and 64
age and sex-matched healthy subjects were studied. All patients
underwent a complete echocardiography including measurement
of the following parameters: Left ventricular ejection fraction
(LVEF) and left ventricular end-diastolic volume index (LVEDVi) by
biplane method, cardiac index (CI), mitral E to Ea lateral ratio
(E/Ea) and tricuspid regurgitation peak velocity (TRV). The exams
were reviewed; each parameter was the average of 3 measure-
ments.
Results.— The observed values of LVEDVi, LVEF and E/Ea in patients
were signiﬁcantly different than the corresponding values observed
in the control group. However, no patient had LVEF < 50% and no
patient had E/Ea ratio > 15.
CI and TRV were similar in the two groups (Table 1).
Conclusion.— Contrary to the patients with homozygous sickle cell
disease, patients with hemoglobin sickle cell disease have only a
mild left ventricular remodelling. In these patients, pulmonary pres-
sure appears to be normal.


Impact of segmental hypertrophy on global and regional left ventricular deformation in hypertrophic cardiomyopathy: A 3D speckle tracking imaging study 

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Impact of segmental hypertrophy on global and regional left ventricular deformation in hypertrophic cardiomyopathy: A 3D speckle tracking imaging study

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