Journal of the American Society of Echocardiography
Volume 23, Issue 4 , Page 456, April 2010

Left Atrial Volume Index: A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy

University of Medicine and Dentistry of New Jersey, Camden, NJ

published online 08 February 2010.

Article Outline

 

To the Editor:

I read with great interest the report by Yang et al1 on the value of the left atrial (LA) volume index for predicting adverse outcome in patients with hypertrophic cardiomyopathy. The article raises the following concerns.

Mitral regurgitation grade > 2 was present in 8 patients, and 23 patients (28%) had left ventricular (LV) outflow tract obstructions. In patients with hypertrophic cardiomyopathy, the dilation of the left atrium is associated with the degree of the LV outflow tract obstruction and the severity of mitral regurgitation.2 Did the LA volume index remain a predictor of adverse outcomes in patients without mitral regurgitation and without LV outflow tract obstructions?

An improvement in LV diastolic function and a decrease in LA volume after surgical septal myectomy in patients with hypertrophic cardiomyopathy have been reported.3 Also, alcohol septal ablation leads to a decrease in LA volume in patients with this disease.4 Considering that alcohol septal ablation and myectomy influence outcomes, did the LA volume index remain a predictor of adverse outcome in patients who benefited from these procedures compared with patients who did not undergo septal intervention?

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References 

  1. Yang WI, Shim CY, Kim YJ, Kim SA, Rhee SJ, Choi EY, et al. Left atrial volume index: a predictor of adverse outcome in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2009;22:1338–1343
  2. Menon SC, Ackerman MJ, Cetta F, O'Leary PW, Eidem BW. Significance of left atrial volume in patients < 20 years of age with hypertrophic cardiomyopathy. Am J Cardiol. 2008;102:1390–1393
  3. Menon SC, Ackerman MJ, Ommen SR, Cabalka AK, Hagler DJ, O'Leary PW, et al. Impact of septal myectomy on left atrial volume and left ventricular diastolic filling patterns: an echocardiographic study of young patients with obstructive hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2008;21:684–688
  4. Hage FG, Karakus G, Luke WD, Suwanjutah T, Burri MV, Nanda NC, et al. Effect of alcohol-induced septal ablation on left atrial volume and ejection fraction assessed by real time three-dimensional transthoracic echocardiography in patients with hypertrophic cardiomyopathy. Echocardiography. 2008;25:784–789

PII: S0894-7317(09)01202-4

doi:10.1016/j.echo.2009.12.016

Refers to article:

  • Left Atrial Volume Index: A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy , 02 November 2009

    Woo-In Yang, Chi Young Shim, Young Jin Kim, Sung-Ai Kim, Sang Jae Rhee, Eui-Young Choi, Donghoon Choi, Yangsoo Jang, Namsik Chung, Seung-Yun Cho, Jong-Won Ha
    Journal of the American Society of Echocardiography December 2009 (Vol. 22, Issue 12, Pages 1338-1343)

Journal of the American Society of Echocardiography
Volume 23, Issue 4 , Page 456, April 2010

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