Predictor and Risk Factor Evaluation of Left Ventricular Free Wall Reverse Remodeling in Patients With Obstructive Hypertrophic Cardiomyopathy After Modified Morrow Procedure by Three-layer Speckle Tracking of Echocardiography / 中国循环杂志

ABSTRACT

Objectives: To evaluate the predictor and risk factor of left ventricular (LV) free wall reverse remodeling in patients with obstructive hypertrophic cardiomyopathy (HCM) after modiifed Morrow procedure by three-layer speckle tracking of echocardiography. Methods: Our investigation included 2 groups HCM group, n=60 patients who had successful modified Morrow procedure in our hospital from 2014-06 to 2014-12, there were 41 (68.3%) male with the average age of (39.1 ± 15.2) years. Control group, n=40 healthy subjects. Three-layer speckle tracking echocardiography was conducted to analyze pre-and post-operative LV free wall three-layer myocardium (endocardial, mid, and epicardial layers) changes at longitudinal strain (LS) and circumferential strain (CS). Clinical and echocardiography information were collected at pre-and (6-24) months post-operation. The impact factors for LV free wall reverse remodeling was identiifed by liner regression analysis and the segment’s thickness≥15mm was deifned as the hypertrophic LV free segment. Results: In HCM group, compared with pre-operative condition, the post-operative thickness of LV free wall including anterior, anterolateral and inferolateral were reduced;while both post-operative LS and CS elevated (-13.8 ± 4.8)%vs (-17.0 ± 5.2)%and (-23.7 ± 3.8)%vs (-25.4 ± 3.7)%, P Conclusion:①After modiifed Morrow procedure, LVOT obstruction disappeared which leaded LV free wall reverse remodeling in HCM patients, ②three-layer myocardium of LV free wall all had reverse remodeling, ③better improved LVOT gradient were with less number of hypertrophic segments;the elder patients usually had the better post-operative reverse remodeling.