4.1 Article

Global Longitudinal Strain as an Efficient Prognostic Tool in Hypertrophic Cardiomyopathy With Preserved Left Ventricular Ejection Fraction

Journal

CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 14, Issue 10, Pages -

Publisher

CUREUS INC
DOI: 10.7759/cureus.30573

Keywords

ejection fraction; hypertrophic cardiomyopathy; speckle tracking; myocardial strain; speckle echo

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This case illustrates the utility of GLS as an additional prognostic marker for cardiovascular complications in patients with HCM, highlighting the potential need for anticoagulation therapy and implantable cardioverter defibrillator placement. Therefore, GLS plays a crucial role in improving clinical management and prognosis.
Intending to demonstrate the utility of the global longitudinal strain (GLS) in patients with hypertrophic cardiomyopathy (HCM) and preserved ejection fraction, we describe a case of a 54-year-old female who presented to our emergency department with an acute onset of palpitations and chest pain. The patient was noted to have a new onset of atrial fibrillation. An echocardiogram showed an unimpaired ejection fraction suggesting normal left ventricular systolic function with findings of concentric left ventricular and apical hypertrophy. However, the speckled ultrasound revealed a GLS of-6.2%, suggesting marked impairment of ventricular wall movement. A CHA2DS2-VASc score was calculated and yielded a score of 2, indicating a moderate risk for thromboembolism. After a full evaluation of the case, the patient was started on anticoagulation due to her GLS result that suggested stasis within the left ventricle that may lead to a thrombus. Additional advice was to follow up closely for possible automatic implantable cardioverter defibrillator placement. We conclude that GLS is a cheap and easy tool to utilize as an additional prognostic marker for cardiovascular complications, particularly among those who have progression of HCM or start with symptoms such as atrial fibrillation and may have impaired left ventricular systolic function despite a preserved ejection fraction. Thus, we encourage the medical community to utilize and further study this novel technology.

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