Journal of the American Society of Echocardiography
Volume 23, Issue 10 , Pages 1090-1098, October 2010

Left Atrial Dysfunction as a Correlate of Heart Failure Symptoms in Hypertrophic Cardiomyopathy

  • Monica Roşca, MD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Bogdan A. Popescu, MD, PhD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • Corresponding Author InformationReprint requests: Bogdan A. Popescu, MD, PhD, FESC, “Carol Davila” University of Medicine and Pharmacy, “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Şos. Fundeni 258, sector 2, 022328 Bucharest, Romania.
    • ,
  • Carmen C. Beladan, MD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Andreea Călin, MD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Denisa Muraru, MD

      Affiliations

    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Elena C. Popa, MD

      Affiliations

    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Patrizio Lancellotti, MD, PhD

      Affiliations

    • Department of Cardiology, University Hospital Sart Tilman, Liege, Belgium
    • ,
  • Roxana Enache, MD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • ,
  • Ioan M. Coman, MD, PhD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Ruxandra Jurcuţ, MD, PhD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania
    • ,
  • Mihai Ghionea, MD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • ,
  • Carmen Ginghină, MD, PhD

      Affiliations

    • “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
    • “Prof. Dr. C. C. Iliescu” Institute of Cardiovascular Diseases, Bucharest, Romania

published online 26 August 2010.

Background

Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We aimed to assess left atrial (LA) function by two-dimensional speckle tracking echocardiography and its relation with left ventricular (LV) function and clinical status in patients with HCM.

Methods

We prospectively enrolled 37 consecutive patients with HCM and 37 normal subjects with similar age and gender distribution. Longitudinal LV strain (ε) and LA ε and strain rate (Sr) parameters (systolic, early diastolic, and late diastolic during atrial contraction) were assessed.

Results

Peak LAε and LA Sr parameters were significantly lower in patients compared with controls (P ≤ .001 for all). In patients, all LA function parameters correlated with LVε (P < .003 for all). Indexed LA volume, LA function parameters, and mitral regurgitation degree were the main correlates of New York Heart Association class; late diastolic strain rate during atrial contraction was the only independent predictor of symptomatic status.

Conclusion

In patients with HCM, LA function is significantly reduced and related to LV dysfunction. Moreover, LA booster pump function emerged as an independent correlate of heart failure symptoms in this setting.

Keywords: Deformation imaging, Hypertrophic cardiomyopathy, Left atrium, Left ventricle, Speckle tracking echocardiography

Abbreviations: ASr, Late diastolic strain rate during atrial contraction, ESr, Early diastolic strain rate, HCM, Hypertrophic cardiomyopathy, LA, Left atrial, LAVi, LA volume indexed to body surface area, LV, Left ventricular, NYHA, New York Heart Association, Sr, Strain rate, SSr, Systolic strain rate, STE, Speckle-tracking echocardiography

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 Conflict of Interest: none

 Funding: This work was supported by Romanian National Research Programme II grants: CNCSIS –UEFISCSU, project number PNII – IDEI 2008 code ID_447 (contract 1208/2009) and CNCSIS –UEFISCSU, project number PNII – IDEI 2007 code ID_222 (contract 199/2007).

PII: S0894-7317(10)00645-0

doi:10.1016/j.echo.2010.07.016

Journal of the American Society of Echocardiography
Volume 23, Issue 10 , Pages 1090-1098, October 2010

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