To evaluate longitudinal and radial left ventricular (LV) dyssynchrony in patients with left ventricular hypertrophy (LVH), and to compare abnormalities associated with hypertrophic cardiomyopathy (HCM) and LVH second to hypertensive heart disease (HLVH) using 2D speckle tracking imaging.

2D fort chamber longaxis and basal, middle, and apical short-axis of LV images were acquired in 97patients with LVH including 67 with HCM and 30 with HLVH, and in 30 age-matched controls. Radial strain, longitudinal strain, time interval from the R-wave to peak radial strain (Trs), and time to peak longitudinal strain (Tls) were measured in six equidistant segments at each level of the 3 LV short-axis and 4C long-axis views using 2D speckle tracking analysis. To assess LV dyssynchrony, Trs (rs)-18SD, the standard deviation (SD) of Tls (ls) was calculated.

Regional radial strain in the middle and apical short-axis segments was significantly less in patients with HCM than in those with HHD (56%±23 VS 45%±21 and 47%±19 VS 38%±17respectevely, p<0.01). Regional longitudinal basal strain was also less in HCM (–13±3.3% VS –17± 2.9%, p=0.002). Trs-18SD and Tls were significantly longer in patients with HCM than in age-matched controls and patients with HLVH (Trs-18SD: HCM: 68±22ms, HHD: 21±11ms, control: 15±12ms P < 0.001, Tls – : HCM: 7 – ±12ms, HHD: 44±11ms, control: 33±13ms P < 0.001).

The presence of LVH is thus not always associated with LV dyssynchrony. However, the greater reduction of regional strain and severe LV dyssynchrony in HCM may contribute to the adverse cardiovascular outcomes associated with this disease.