Hypertrophic cardiomyopathy (HCM) significantly contributes to an elevated risk of sudden cardiac death. Primary prevention is implemented by using an implantable cardioverter defibrillator (ICD). However, all of the HCM patients do not really need ICD therapy. Providing a superior index for ICD indication compared with the current indices like ejection fraction is essential to differentiate high-risk patients efficiently. The present study assessed the potential of global longitudinal strain (GLS) for the differentiation of HCM patients based on their need for ICD shocks. Patients with HCM were considered in four defined centers between March and June 2021. Those with previous ICD implantation or current candidates for ICD therapy were included in the study. Participants were subjected to speckle-tracking echocardiography, and GLS as well as some other echocardiographic parameters were recorded. Afterwards, data from implanted ICDs were extracted. Patients who received ICD shocks (appropriate) due to ventricular tachycardia (VT)/ventricular fibrillation (VF) were categorized in group A. The remaining patients were constituted group B who received inappropriate shocks, i.e., other than VT/VF. Overall, 34 patients were found eligible to participate with a mean age of 62 ± 16.1 years including 64.7% of males. Among a variety of echocardiographic parameters, GLS was the sole one that was significantly higher in group A compared with that in group B. Our findings revealed that only GLS could predict fatal arrhythmias. To substantiate, the odds of VT were raised by 43% with a single increase in GLS unit. GLS showed the highest accuracy for ICD indication among HCM patients and, therefore, could be a solid and early criterion to predict the incidence of life-threatening arrhythmias. In this regard, identifying appropriate HCM patients with respect to their need for ICD therapy is feasible.

中文翻译：

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全局纵向应变可能是适当识别 ICD 植入候选者的一种方法

肥厚型心肌病（HCM）显着增加心源性猝死的风险。一级预防是通过使用植入式心脏复律除颤器 (ICD) 来实施的。然而，并非所有 HCM 患者都真正需要 ICD 治疗。与射血分数等现有指标相比，为 ICD 适应症提供更优越的指标对于有效区分高危患者至关重要。本研究根据 HCM 患者对 ICD 电击的需要评估了整体纵向应变 (GLS) 区分 HCM 患者的潜力。2021 年 3 月至 6 月期间，四个指定中心考虑了 HCM 患者。之前植入过 ICD 或当前接受 ICD 治疗的候选者均纳入研究。参与者接受了斑点追踪超声心动图检查，并记录了 GLS 以及其他一些超声心动图参数。随后，从植入的 ICD 中提取数据。由于室性心动过速（VT）/心室颤动（VF）而接受 ICD 电击（适当）的患者被分为 A 组。其余患者被视为接受不适当电击（即除 VT/VF 之外）的 B 组。总体而言，共有 34 名患者符合参与资格，平均年龄为 62 ± 16.1 岁，其中 64.7% 为男性。在各种超声心动图参数中，GLS 是唯一一个 A 组显着高于 B 组的参数。我们的研究结果表明，只有 GLS 可以预测致命性心律失常。为了证实这一点，单次增加 GLS 单位，VT 的几率就增加了 43%。GLS 显示 HCM 患者中 ICD 适应症的最高准确性，因此可以成为预测危及生命的心律失常发生率的可靠早期标准。在这方面，根据 ICD 治疗的需要确定合适的 HCM 患者是可行的。