Impaired left ventricular global longitudinal strain is associated with diastolic dysfunction in obstructive hypertrophic cardiomyopathy.

OBJECTIVES

Left ventricular global longitudinal strain (LV-GLS) provides additional insight into subtle myocardial contractile impairment in hypertrophic cardiomyopathy (HCM). However, its clinical value in evaluating diastolic dysfunction remains insufficiently characterized. The primary objective of this study was to investigate the association between LV-GLS and the severity of diastolic dysfunction in symptomatic hypertrophic obstructive cardiomyopathy (HOCM) patients with preserved LVEF, and to assess the potential utility of LV-GLS for grading diastolic dysfunction in this patient cohort.

METHODS

A total of 145 consecutive symptomatic HOCM patients were enrolled and classified into diastolic dysfunction grade I or grade II according to the ASE-recommended algorithm. Multivariate regression analysis was performed to identify independent factors associated with the severity of diastolic dysfunction.

RESULTS

Among the 145 patients, 109 (75.2%) had grade II and 36 (24.8%) had grade I diastolic dysfunction. Grade II dysfunction was more common among females. Greater myocardial wall thickness, elevated BNP levels, and reduced LV-GLS were independently associated with more advanced diastolic dysfunction, irrespective of loading conditions and preserved LVEF. Receiver operating characteristic analysis demonstrated that LV-GLS effectively discriminated diastolic dysfunction grade, with an area under the curve (AUC) of 0.728 (p = 0.001).

CONCLUSIONS

Reduced LV-GLS was independently associated with more advanced diastolic dysfunction in symptomatic HOCM patients with preserved LVEF. LV-GLS provides incremental value for grading diastolic dysfunction and could improve risk stratification for heart failure with preserved ejection fraction in this population. CLINICAL TRIAL NUMBER: Not applicable.