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Hypertrophic cardiomyopathy (HCM) is a common genetic cardiovascular disease. Outflow-tract gradient of 30 mmHg or more under resting conditions is an independent determinant of symptoms of progressive heart failure and death.
The investigators hypothesize that the electrical approach by dual chamber pacing could improve symptoms and reduce outflow-tract obstruction in a specific sub-group of selected patients with a mechanical hyper-synchronicity. The aim of the study is to identify and describe this phenomenon in HCM with (O-HCM) and without (NO-HCM) outflow-tract obstruction thanks to innovative multi-imaging approach.
The concept of physiological ventricular desynchrony was described recently with technics of myocardial deformation analysis applied in animal models. Authors confirmed the existence of a time delay in the contraction of the apical walls before basal walls. In O-HCM, the outflow-tract obstruction could be explained by a mechanical hyper-synchronicity between apical and basal walls. This study aims to describe the possible hyper-synchronized contraction in O-HCM and NO-HCM patients unlike the physiological desynchrony observed in healthy volunteers (HV) For this purpose, three imaging tests will be used at baseline: echocardiography (TEE), magnetic resonance imaging (MRI) with gadolinium enhancement only in HCM, and 3-dimensional electrocardiographic mapping (ECM) combined with computed tomography-scan. No follow-up is planned for this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| O-HCM | Experimental | 20 patients with Hypertrophic Cardiomyopathy with outflow-tract obstruction |
|
| NO-HCM | Experimental | 20 patients with Hypertrophic Cardiomyopathy without outflow-tract obstruction |
|
| healthy volunteers | Other | 20 healthy volunteers |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Echocardiography (TEE) | Procedure |
| ||
| Magnetic resonance imaging (MRI) with gadolinium enhancement |
| Measure | Description | Time Frame |
|---|---|---|
| Mechanical time delay in contraction between basal and apical walls in TEE and MRI in O-HCM, NO-HCM and healthy volunteers | The main interest variable is the delay value (ms) of the contraction between basal and apical walls measured by TEE and MRI. | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Relationship between each mesure with hyper-synchronicity and outflow-tract gradient | Day 1 | |
| Electrical time delay in ECM between basal and apical walls and relationship with hyper-synchronicity and outflow tract gradient. | Day 1 |
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Inclusion Criteria:
Exclusion Criteria:
- HV: unusable acoustic window
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| Name | Affiliation | Role |
|---|---|---|
| Claire CORNOLLE, Dr | University Hospital, Bordeaux | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU de Bordeaux | Bordeaux | 33000 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38911519 | Derived | Reant P, Bonnet G, Dube F, Massie C, Reynaud A, Michaud M, Duchateau J, Lafitte S. Hypersynchrony in sarcomeric hypertrophic cardiomyopathy: description and mechanistic approach using multimodal electro-mechanical non-invasive cartography (HSYNC study). Front Cardiovasc Med. 2024 Jun 7;11:1359657. doi: 10.3389/fcvm.2024.1359657. eCollection 2024. |
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| Device |
|
| Magnetic resonance imaging (MRI) without gadolinium enhancement | Device |
|
| 3D electrocardiographic mapping (ECM) | Procedure |
|
|
| Mechanical time delay between septal and lateral walls in MRI and TEE. | Day 1 |
| Evolution of mechanical time delay between basal and apical walls at rest and exercise in O-HCM and NO-HCM and relationship with outflow-tract gradient. | Day 1 |
| Delay between peaks of basal and apical radial displacement in MRI | Day 1 |
| Delay between the beginning of the apical and basal radial displacement in MRI | Day 1 |
| Apical-basal phase on a phase analysis of the radial displacement data in MRI | Day 1 |
| Delay between apical and basal peaks circumferential strain in MRI | Day 1 |
| Delay between the beginning of the apical and basal circumferential deformation in MRI | Day 1 |
| Twist angle between the base and the apex in MRI | Day 1 |
| ID | Term |
|---|---|
| D002312 | Cardiomyopathy, Hypertrophic |
| ID | Term |
|---|---|
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001020 | Aortic Stenosis, Subvalvular |
| D001024 | Aortic Valve Stenosis |
| D000082862 | Aortic Valve Disease |
| D006349 | Heart Valve Diseases |
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| ID | Term |
|---|---|
| D008279 | Magnetic Resonance Imaging |
| ID | Term |
|---|---|
| D014054 | Tomography |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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