The early diagnosis of MYH7 gene mutation carriers of hypertrophic cardiomyopathy using multi-parameter analysis model by conventional two-dimensional echocardiography and three-dimensional speckle tracking imaging / 中华超声影像学杂志

ABSTRACT

Objective To create multi-parameter analysis model by conventional two-dimensional echorcardiography( 2DE) and three-dimensional speckle tracking imaging( 3D-STI) in order to improve the early diagnosis in MYH7G + P- mutation carriers of familiar hypertrophic cardiomyopathy( HCM ) . Methods Twenty-eight MYH7 mutation carriers without left ventricular hypertrophy ( MYH7G + P- ) were enrolled as the research group , while 27 MYBPC3 mutation carriers without left ventricular hypertrophy ( MYBPC3G + P- ) were selected as the control group . The clinical data ,conventional 2DE and tissue Doppler imaging ( TDI) parameters of the two groups were acquired ,including the maximum of the thickness of interventricular septum( IVS) and left ventricular posterior ventricular wall thickness( LVPWT ) in end of diastole ,mitral flow E and A velocities ,E peak deceleration time( EDT ) ,atrioventricular filling time ,mitral annulus velocity of interventricular septum IVS-e' and lateral wall L-e' ,interventricular septum IVS-a' and lateral wall L-a' peak in diastole ,calculate mean value e' and a' ,and calculate E/ e' ,E/A ,left atrial volume index( LAVI) ,left ventricular mass index( LVMI) ,left ventricular ejection fraction( LVEF) and isovolumic relaxation time( IVRT ) ,isovolumic contraction time( IVCT ) . The global longitudinal peak strain( GLS) , global radial peak strain( GRS) ,global circumferential peak strain( GCS) and global area peak strain( GAS) were acquired by 3D-STI . All parameters were compared between research group and control group . Results Compared with the control group ,research group significantly increased in LAVI , maximum IVS and LVPWT ,LVMI and GAS( P < 0 .01) . There were no significant difference in TDI parameters( P > 0 .05) . For single parameter ,the area under ROC curve( AUC) were successively LVPWT > LAVI > IVS > LVMI >GAS( 0 .772 ,0 .738 ,0 .733 ,0 .719 ,0 .714 ,respectively) . AUC of multi-parameters was 0 .912 ,the sensitivity and specificity were 85 .2％ and 96 .3％ ,respectively . Conclusions Multi-parameter analysis model by conventional 2DE and 3D-STI can significantly improve the recognition efficiency of early diagnosis MYH7G + P- of familiar HCM . With further ,maximum LVPWT is an independent predictor of distinction MYH7G + P- and MYBPC3G + P- .