Segmental Left Ventricular Strain Changes and Mortality Risk After Septal Myectomy for Hypertrophic Obstructive Cardiomyopathy
Presented During:
Monday, May 4, 2026: 9:00AM - 4:00PM
McCormick Place Lakeside Center
Posted Room Name:
Exhibit Hall, Poster Area
Abstract No:
P0153
Submission Type:
Abstract Submission
Authors:
Olga Kislitsina (1), Lubna Choudhury (1), Kifah Hussain (1), Bonnie Kane (1), James Thomas (1), Abigail Baldridge (1), Seokyung An (1), Jane Kruse (2), James Cox (1), Patrick McCarthy (1), Douglas Johnston (1)
Institutions:
(1) Northwestern University, Chicago, IL, (2) Northwestern Medicine, Chicago, IL
Submitting Author:
Olga Kislitsina
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Northwestern University
Northwestern University
Co-Author(s):
Lubna Choudhury
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Northwestern University
Northwestern University
Kifah Hussain
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Northwestern University
Northwestern University
Bonnie Kane
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Northwestern University
Northwestern University
James Thomas
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Northwestern University
Northwestern University
Abigail Baldridge
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Northwestern University
Northwestern University
Seokyung An
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Northwestern University
Northwestern University
Jane Kruse
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Northwestern Medicine
Northwestern Medicine
James Cox
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Northwestern University
Northwestern University
*Patrick McCarthy
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Northwestern University
Northwestern University
*Douglas Johnston
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Northwestern University
Northwestern University
Presenting Author:
Olga Kislitsina
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Northwestern University Feinberg School of Medicine
Northwestern University Feinberg School of Medicine
Abstract:
Objective: The changes in regional left ventricular (LV) myocardial strain that follow septal myectomy for hypertrophic obstructive cardiomyopathy (HOCM) are not well defined. The LV regions that are typically involved and most frequently targeted during surgery are the basal anterior and mid-anterior septum, and the basal inferior free-wall. This study was designed to evaluate potential relationships between pre-and post-myectomy changes in segmental LV strain and postoperative mortality.
Methods: We retrospectively analyzed 187 HOCM patients who underwent speckle-tracking segmental strain analysis preoperatively and one year following septal myectomy. Logistic regression models adjusted for demographics, clinical risk factors, and systolic anterior motion of the mitral valve were used to assess segmental strain associations with postoperative mortality.
Results: The mean age was 56.9 ± 15.6 years. Baseline LV global longitudinal strain (LVGLS) was -18.6% (Q1-Q3: -20.3, -16.5), and LV ejection fraction was 66.3% (61.6, 72.7). At 1 year, GLS showed minimal overall change. Segment 3 (basal anteroseptal) improved slightly (+0.6 percentage points [pp], p=0.04) but was not independently associated with mortality. Preoperative segment 4 (basal inferoseptal) independently predicted higher postoperative mortality (OR 1.10 per 1-pp less negative strain, p=0.05)-approximately 10% higher risk per 1-pp worsening. Preoperative segment 12 (mid-anterolateral) was associated with improved survival (OR 0.90 per 1-pp more negative, p=0.05)-approximately 10% lower risk per 1-pp improvement. Postoperative segment 10 (mid-inferior) improvement was associated with lower mortality (OR 0.71 per 1-pp more negative, p=0.05)- approximately 29% lower risk per 1-pp improvement (Figure1).
Conclusions: Preoperative and post-myectomy segmental LV strain analysis identifies prognostically significant regions, particularly the basal inferior septal segment 4. Improved strain in this LV segment post-myectomy markedly reduces mortality risk. Targeted monitoring of segment-specific LV strain provides valuable prognostic insight and preoperative risk stratification and postoperative management strategies for HOCM patients undergoing septal myectomy.
Methods: We retrospectively analyzed 187 HOCM patients who underwent speckle-tracking segmental strain analysis preoperatively and one year following septal myectomy. Logistic regression models adjusted for demographics, clinical risk factors, and systolic anterior motion of the mitral valve were used to assess segmental strain associations with postoperative mortality.
Results: The mean age was 56.9 ± 15.6 years. Baseline LV global longitudinal strain (LVGLS) was -18.6% (Q1-Q3: -20.3, -16.5), and LV ejection fraction was 66.3% (61.6, 72.7). At 1 year, GLS showed minimal overall change. Segment 3 (basal anteroseptal) improved slightly (+0.6 percentage points [pp], p=0.04) but was not independently associated with mortality. Preoperative segment 4 (basal inferoseptal) independently predicted higher postoperative mortality (OR 1.10 per 1-pp less negative strain, p=0.05)-approximately 10% higher risk per 1-pp worsening. Preoperative segment 12 (mid-anterolateral) was associated with improved survival (OR 0.90 per 1-pp more negative, p=0.05)-approximately 10% lower risk per 1-pp improvement. Postoperative segment 10 (mid-inferior) improvement was associated with lower mortality (OR 0.71 per 1-pp more negative, p=0.05)- approximately 29% lower risk per 1-pp improvement (Figure1).
Conclusions: Preoperative and post-myectomy segmental LV strain analysis identifies prognostically significant regions, particularly the basal inferior septal segment 4. Improved strain in this LV segment post-myectomy markedly reduces mortality risk. Targeted monitoring of segment-specific LV strain provides valuable prognostic insight and preoperative risk stratification and postoperative management strategies for HOCM patients undergoing septal myectomy.
ADULT CARDIAC:
Hypertrophic Obstructive Cardiomyopathy
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