Objectives: A new method to measure strain from standard two-dimensional (2D) images has been recently proposed. Aim of this study, was to characterize global and regional systolic function abnormalities with this method in two groups of patients, with hypertrophic cardiomyopathy (HCM) and with left ventricular hypertrophy secondary to aortic stenosis, (AS) versus a control population.

Background: Strain study has been proposed as a sensitive tool to detect early systolic function abnormalities. However, the clinical application of conventional Doppler-derived strain has been limited and the new 2D-strain capabilities provide an opportunity to measure longitudinal and transverse (radial) function for the same regions of interest.

Methods: Echocardiographic examinations were performed in 9 patients with nonobstructive HCM, 11 significant AS cardiomyopathies and 9 control subjects. Using a dedicated software package (Echopac, GE-Healthcare), 2D acquisitions were analyzed to measure longitudinal and radial strains in apical views. Statistical comparison was performed using a one-way ANOVA.

Results: They are summarised in table 1. Ejection fraction (Simpson method) and pulsed tissue Doppler at the mitral annulus parameters were not different in the three groups. Longitudinal function was decreased (table, p < 0.01) in AS patients and radial function was decreased in HCM (p < 0.01) patients. Average interobserver and intraobserver variabilities were 11 % and 11.3 %, respectively.

Conclusions: Two-dimensional strain is a new simple, rapid, and reproducible method to measure different components of systolic strain. This technique identified early abnormalities in patients with cardiac hypertrophy that have apparently normal left ventricular systolic function.