الفهرس 
Hypertrophic cardiomyopathyOnly 14 pages are availabe for public view
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Abstract
Hypertrophic cardiomyopathy is characterized by an increased thickness of heart
muscle typically consisting of asymmetric septal hypertrophy, and SAM of the mitral
valve. Resting LVOTO due to SAM is observed in 25% to 30% of HCM patients and,
when severe, cause dyspnea, chest pain, syncope, and a predisposition to developing atrial
arrhythmias.
Recently, 2D strain imaging has emerged as novel deformation non-invasive
imaging that can identify segmental myocardial function and differentiate between active
and passive movement of myocardial segments.
Brain natriuretic peptide, originally isolated from the mammalian brain, is a
novel natriuretic peptide with striking structural and biologic similarities to atrial
natriuretic peptide.
In the human heart, brain natriuretic peptide is synthesized primarily by the
ventricles, and its expression in the ventricles is greatly accelerated in ventricular
overload and hypertrophy, causing congestive heart failure.
The aim of the present study was to know if there is relationship of cardiac
mechanics to Brain natriuretic peptide serum level in patients with hypertrophic
cardiomyopathy.
This is a prospective study that included 70 patients with HCM .
the diagnosis of HCM is based on typical clinical, electrocardiographic, and
echocardiographic features, and 20 age and sex matched healthy volunteers. They were
subdivided into three groups:
I- Control group: persons with age and sex matched healthy volunteers.
II- Patients with Hypertrophic Cardiomyopathy ( obstructive – non obstructive ) .
The summary of our results
1- High BNP level was associated with larger left atrial diameter, MWT, more severe
mitral regurgitation and lower E’ velocity and early diastolic SRe..
2- High BNP level was associated with more frequent hospitalization 16(42%) versus
2(6.3%).
3- group II had high statistically significant increase than the other groups regarding
BNP with mean of (466.1±112.5).
4- HCM ( group II,III )had markedly increased LA diameter, MWT, LV mass index,
LVOT gradient, and E/é in comparison to control group (group I ). Also, LV
mechanics as assessed by global longitudinal εsys %, showed reduced LV GLS,
SRsys, SRe, and SRa as compared to control group (P<0.001).
5- There was high statistically significant difference between group I and group II
regarding all conventional echocardiography parameters. Also, there was
statistically significant difference between group I and group III regarding all
conventional echocardiography parameters except for resting LVOT gradient.
6- There was no statistically significant difference between BNP levels of the studied
patients regarding age, gender body surface area, heart rate, systolic and diastolic blood pressure.