Three-Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy-Insights from the MAGYAR-Path Study

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 31; no. 10; pp. 1245 - 1252
• Main Authors: Domsik, Péter, Kalapos, Anita, Chadaide, Számi, Sepp, Róbert, Hausinger, Péter, Forster, Tamás, Nemes, Attila
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.11.2014
• Subjects: Adult; Atrial Function, Left - physiology; Cardiomyopathy, Hypertrophic - diagnostic imaging; Cardiomyopathy, Hypertrophic - physiopathology; Case-Control Studies; Chi-Square Distribution; echocardiography; Echocardiography - methods; Echocardiography, Three-Dimensional; Female; function; Humans; hypertrophic cardiomyopathy; Image Interpretation, Computer-Assisted; left atrium; Male; Middle Aged; Prognosis; Reference Values; Severity of Illness Index; speckle tracking; three-dimensional; Ventricular Dysfunction, Left - diagnostic imaging; speckle tracking; hypertrophic cardiomyopathy; three-dimensional; left atrium; echocardiography; function
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/echo.12568

Introduction Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. Reduced left atrial (LA) function was demonstrated in HCM by different methods. Three‐dimensional (3D) speckle tracking echocardiography (STE) has just been introduced for the evaluation of LA. This study was designed to compare 3DSTE‐derived LA volumetric and strain parameters in HCM with healthy controls. Methods The study comprised 23 consecutive HCM patients (mean age: 48.5 ± 15.1 years, 14 men). Their results were compared to 23 age‐ and gender‐matched healthy controls. Complete two‐dimensional Doppler echocardiography and 3DSTE have been performed in all cases. Results Calculated LA maximum (66.4 ± 20.4 mL vs. 36.0 ± 6.1 mL, P < 0.0001) and minimum (39.2 ± 19.1 vs. 16.0 ± 4.6 mL, P < 0.0001) volumes and LA volume before atrial contraction (53.6 ± 19.9 vs. 24.0 ± 6.2 mL, P < 0.0001) were significantly increased in HCM patients. Atrial stroke volumes respecting cardiac cycles proved to be increased, while emptying fractions were decreased in subjects with HCM. Mean global radial (−12.2 ± 6.7% vs. −19.6 ± 11.7, P < 0.05), longitudinal (26.5 ± 16.5% vs. 29.8 ± 12.1%, P < 0.05) and 3D strain (−6.1 ± 4.4% vs. −12.5 ± 10.2%, P < 0.05) proved to be significantly reduced in HCM patients as compared with matched controls. Conclusions Three‐dimensional speckle tracking echocardiography allows detailed evaluation of LA (dys) function in HCM by volumetric and strain measurements.