2D speckle tracking in echocardiography in hypertrophic cardiomyopathy and its relation to hypertrophy and late gadolinium enhancement extent

Abstract Introduction The relationship between cardiac deformation by 2D speckle tracking, hypertrophy, and the extent of late gadolinium enhancement (LGE) in patients with hypertrophic cardiomyopathy remains uncertain. Our study aims to compare left ventricular global longitudinal strain (GLS) with the extent of LGE and to determine a relationship between GLS and hypertrophy. Methods We conducted a descriptive cross-sectional single-center study that included patients aged 16 or above. Participants underwent echocardiography and cardiac MRI. GLS was assessed through 2D speckle tracking. LV mass index and LGE extent (LGE% = LGE volume/ LV mass) were calculated from MRI. Patients were divided into three groups based on LGE extent for analysis (LGE extent = 0; < 15%; ≥ 15%), Results Forty-two patients were included, 15 having a LGE extent ≥ 15%, 16 having an extent < 15%, and 11 having no LGE. Patients with LGE ≥ 15% had significantly lower global longitudinal strain, higher LV mass index, and higher maximal wall thickness compared to those without LGE ( p = 0.016 , p = 0.025 , and p= 0.003, respectively). A GLS cutoff value of -13.95 % predicted a LGE extent ≥15% with a specificity of 63% and sensitivity of 66.7%. Area Under the Curve (AUC) of 0.691 (95% CI 0.515 - 0.868) p =0.042. Patients with higher LV mass index had lower GLS ( p <0.0001). Conclusions The study suggests a correlation between GLS, LGE extent, and hypertrophy in HCM patients. These findings indicate that GLS could be a promising tool for sudden death risk stratification as the LGE extent.