In cardiac high-frame-rate color tissue Doppler imaging (TDI), a wave-like pattern travels over the interventricular septum (IVS) after atrial contraction. The propagation velocity of this myocardial stretch postatrial contraction (MSPa) was proposed as a measure of left ventricular stiffness. The aim of our study was to investigate the MSPa in patients with hypertrophic cardiomyopathy (HCM) compared with healthy volunteers. Forty-two healthy volunteers and 33 HCM patients underwent high-frame-rate (>500 Hz) TDI apical echocardiography. MSPa was visible in TDI, M-mode and speckle tracking. When assuming a wave propagating with constant velocity, MSPa in healthy volunteers (1.6 § 0.3 m/s) did not differ from that in HCM patients (1.8 § 0.8 m/s, p = 0.14). Yet, in 42% of patients with HCM, the MSPa had a non-constant velocity over the wall: in the basal IVS, the velocity was lower (1.4 § 0.5 m/s), and in the mid-IVS, much higher (6.1 § 3.4 m/s, p < 0.0001), and this effect was related to the septal thickness. The reason is hypothesized to be the reaching of maximal longitudinal myocardial distension in HCM patients. (

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Keywords Myocardial stretch, Atrial contraction, Stiffness, High-frame-rate tissue Doppler
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Journal Ultrasound in Medicine & Biology
Strachinaru, M., Geleijnse, M.L, de Jong, N, van den Bosch, A.E, Michels, M, Schinkel, A.F.L, … Vos, H.J. (2019). MYOCARDIAL STRETCH POST-ATRIAL CONTRACTION IN HEALTHY VOLUNTEERS AND HYPERTROPHIC CARDIOMYOPATHY PATIENTS. Ultrasound in Medicine & Biology, 45(8), 1987–1998. doi:10.1016/j.ultrasmedbio.2019.04.031