The value of myocardial work in assessment of ventricular function in patients with hypertrophic cardiomyopathy

Abstract Background: To evaluate myocardial work using speckle tracking echocardiography in patients with hypertrophic cardiomyopathy (HCM). Methods: Fifty patients with HCM and 50 normal controls were included. Left ventricular ejection fraction (LVEF) was quantified using the bi-plane Simpson’s method. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE), were derived from the 2D strain-pressure loop. Results: The patient group was older (49.19 ± 14.69 versus 37.16 ± 7.49 years old) and had a higher body mass index (24.93 ± 3.67 versus 23.26 ± 3.32 kg/m2) and systolic blood pressure (121.81 ± 16.50 versus 115.30 ± 11.01 mmHg) (P < 0.05). The mean LVEF in patients was 51%, with 54% of patients had LVEF ≤ 50%. Compared to controls, GWI (946.42 ± 360.64 versus 1639.72 ± 204.56 mmHg%), GCW (1176.94 ± 373.23 versus 1960.16 ± 255.72 mmHg%), and GWE (83.96 ± 7.68 versus 95.26 ± 1.98%) were significantly decreased, while GWW (158.17 ± 82.47 versus 79.12 ± 40.26 mmHg%) was significantly increased (P < 0.05) in the patient group. In patients, GWE showed a trend of positive correlation with LVEF (r = 0.276, P = 0.06), while GWW had a trend of negative correlation with LVEF (r = -0.241, P = 0.09). There was no correlation between LVEF and GWI or GCW. Conclusions: Assessing myocardial work adds useful information of LV function in patients with HCM.