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European Journal of Echocardiography Advance Access published online on May 1, 2008
European Journal of Echocardiography, doi:10.1016/j.euje.2007.02.004
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Apical hypertrophic cardiomyopathy: potential utility of Strain imaging

Madhulatha Reddy, Deepak Thatai, Juan Bernal, Jyoti Pradhan and Luis Afonso*

Division of Cardiology, Wayne State University, Harper University Hospital, Detroit Medical Center, Detroit MI 48201

Received 17 December 2006; accepted after revision 4 February 2007; online publish-ahead-of-print 31 March 2007.

* Corresponding author. E-mail address: lafonso{at}med.wayne.edu


  Abstract

Hypertrophic cardiomyopathy (HCM) is a frequently recognized condition on echocardiography. The apical variant, also known as ‘Japanese variant’, is rare and often poses a diagnostic challenge. There has been a resurgence of interest in the diagnosis of HCM especially with the advent of novel imaging modalities such as strain imaging. Two-dimensional (2D) strain echocardiography calculates tissue velocities via frame-to-frame tracking of acoustic markers within the image and provides strain parameters comparable with tissue-Doppler-derived strain. We describe paradoxical apical strain (systolic lengthening) without overt apical dyskinesis (conventional imaging) in two patients with apical HCM, using 2D strain imaging. Our report highlights a novel application of 2D strain imaging that could facilitate the diagnosis of apical HCM.

Keywords: Apical hypertrophic cardiomyopathy; Speckle tracking; Strain imaging


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