Incremental value of left atrial active function measured by speckle tracking echocardiography in patients with hypertrophic cardiomyopathy

Fujimoto, Kazuya; Inoue, Kentaro; Saito, Makoto; Higashi, Haruhiko; Kono, Tamami; Uetani, Teruyoshi; Aono, Jun; Nagai, Takayuki; Nishimura, Kazuhisa; Suzuki, Jun; Okura, Takafumi; Ikeda, Shuntaro; Nakatani, Satoshi; Higaki, Jitsuo

doi:10.1111/echo.13886

Cited by 30 publications

(23 citation statements)

References 25 publications

(40 reference statements)

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“…The data from literature indicate the potential usefulness of the speckle tracking technique in predicting the cardiac events among HCM patients. For example Fujimoto et al proved that LA peak longitudinal strain <20.3% is associated with an increased risk of heart failure and atrial fibrillation in the follow up [17,25]. A similar observation was also presented by the other authors [4,10,15].…”

Section: Discussionsupporting

confidence: 57%

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Comparison of clinical and echocardiographic parameters in patients with hypertrophic cardiomyopathy under and over 60 years of age

Wabich¹,

Daniłowicz‐Szymanowicz²,

Rozwadowska³

et al. 2019

Eur J Trans Clin Med

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Background: Hypertrophic Cardiomyopathy (HCM) is one of the most common genetic myocardial diseases. Transthoracic echocardiography which includes speckle tracking technique is tool for HCM diagnosis and monitoring the course of the disease. The aim of this study was to compare clinical and echocardiographic parameters in HCM patients older and younger than 60 years old (yo). Materials and methods: We prospectively enrolled 53 HCM patients, who were divided into two groups: younger and older than 60 yo. Clinical parameters, standard echocardiographic indices, as well as strain parameters were assessed and compared between the groups. Results: The older subgroup was characterized by a higher prevalence of coronary artery disease. In the younger subgroup the incidence of atrial fibrillation was quite high, which occurs far more often than in the general population. Echocardiographic analysis showed worse diastolic function in older, as well as lower volume of the LV. The global longitudinal strain was worse in <60 patients. The 3D strain parameters differed significantly between the groups: the area and radial strains were worse in younger patients. Conclusions: HCM patients older and younger than 60 yo differ significantly in terms of clinical and echocardiographic parameters.

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Section: Discussionsupporting

confidence: 57%

“…Comparison of clinical and echocardiographic parameters in... Two-and four-chamber apical views were determined by finding the largest long-axis. Due to the absence of an LA-specific software, we used software dedicated to LV analysis as described in the literature [15,17].…”

Section: Speckle Tracking Parametersmentioning

confidence: 99%

Comparison of clinical and echocardiographic parameters in patients with hypertrophic cardiomyopathy under and over 60 years of age

Wabich¹,

Daniłowicz‐Szymanowicz²,

Rozwadowska³

et al. 2019

Eur J Trans Clin Med

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“…However, in contrast to the Kowallick’s study, the LA booster pump function in our study was not statistically different between the NOHCM patients and the normal controls. The LA booster pump functions in previous HCM patient studies in the literature has not been consistent and has been separately reported as normal [30], increased [21] or reduced [12]. LA contraction is influenced by pulmonary venous return (atrial pre-load), LV end-diastolic pressure (atrial after-load), and LV systolic reserve [8].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, analysis of the LA functional parameters of strain and strain rate (SR) using non-invasive imaging modalities such as echocardiography speckle tracking (STE) and cardiovascular magnetic resonance (CMR) feature tracking (CMR-FT) have been proposed for further evaluation. STE has been proven to be a feasible and reproducible technique to evaluate LA function [11] and has demonstrated significant LA function impairment in HCM [12–14]. CMR-FT is a new quantitative method for wall motion assessment that is analogous to STE [15].…”

Section: Introductionmentioning

confidence: 99%

Quantification of left atrial function in patients with non-obstructive hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking imaging: a feasibility and reproducibility study

Yang

Yin

Jiang

et al. 2020

Journal of Cardiovascular Magnetic Resonance

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BackgroundAtrial fibrillation (AF) is the most common arrhythmia in hypertrophic cardiomyopathy (HCM) and is associated with adverse outcomes in HCM patients. Although the left atrial (LA) diameter has consistently been identified as a strong predictor of AF in HCM patients, the relationship between LA dysfunction and AF still remains unclear. The aim of this study is to evaluate the LA function in patients with non-obstructive HCM (NOHCM) utilizing cardiovascular magnetic resonance feature tracking (CMR-FT).MethodsThirty-three patients with NOHCM and 28 healthy controls were studied. The global and regional LA function and left ventricular (LV) function were compared between the two groups. The following LA global functional parameters were quantitively analyzed: reservoir function (total ejection fraction [LA total EF], total strain [εs], peak positive strain rate [SRs]), conduit function (passive ejection fraction [LA passive EF], passive strain [εe], peak early-negative SR [SRe]), and booster pump function (active ejection fraction [LA active EF], active strain [εa], peak late-negative SR [SRa]). The LA wall was automatically divided into 6 segments: anterior, antero-roof, inferior, septal, septal-roof and lateral. Three LA strain parameters (εs, εe, εa) and their corresponding strain rate parameters (SRs, SRe, SRa) during the reservoir, conduit and booster pump LA phases were segmentally measured and analyzed.ResultsThe LA reservoir (LA total EF: 57.6 ± 8.2% vs. 63.9 ± 6.4%, p < 0.01; εs: 35.0 ± 12.0% vs. 41.5 ± 11.2%, p = 0.03; SRs: 1.3 ± 0.4 s− 1 vs. 1.5 ± 0.4 s− 1, p = 0.02) and conduit function (LA passive EF: 28.7 ± 9.1% vs. 37.1 ± 10.0%, p < 0.01; εe: 18.7 ± 7.9% vs. 25.9 ± 10.0%, p < 0.01; SRe: − 0.8 ± 0.3 s− 1 vs. -1.1 ± 0.4 s− 1, p < 0.01) were all impaired in patients with NOHCM when compared with healthy controls, while LA booster pump function was preserved. The LA segmental strain and strain rate analysis demonstrated that the εs, εe, SRe of inferior, SRs, SRe of septal-roof, and SRa of antero-roof walls (all p < 0.05) were all decreased in the NOHCM cohort. Correlations between LA functional parameters and LV conventional function and LA functional parameters and baseline parameters (age, body surface area and NYHA classification) were weak. The two strongest relations were between εs and LA total EF(r = 0.84, p < 0.01), εa and LA active EF (r = 0.83, p < 0.01).ConclusionsCompared with healthy controls, patients with NOHCM have LA reservoir and conduit dysfunction, and regional LA deformation before LA enlargement. CMR-FT identifies LA dysfunction and deformation at an early stage.

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“…20) In HCM patients, Fujimoto, et al have shown that loss of LA active function (evaluated by LA strain) was independently associated with increased cardiac events. 21) When recent insights about LA physiology and function are taken together, it creates a paradigm shift that the LA is no longer simply being a passive marker of disease severity, but an active component of the heart failure in HCM patients. Several questions still remain to be answered.…”

mentioning

confidence: 99%

Left Atrium as an Active Component of the Pathophysiology in HCM

2018

Int. Heart J.

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Incremental value of left atrial active function measured by speckle tracking echocardiography in patients with hypertrophic cardiomyopathy

Abstract: Loss of LA active function was associated with increased cardiac events in patients with HCM.

Cited by 30 publications

References 25 publications

Comparison of clinical and echocardiographic parameters in patients with hypertrophic cardiomyopathy under and over 60 years of age

Comparison of clinical and echocardiographic parameters in patients with hypertrophic cardiomyopathy under and over 60 years of age

Quantification of left atrial function in patients with non-obstructive hypertrophic cardiomyopathy by cardiovascular magnetic resonance feature tracking imaging: a feasibility and reproducibility study

Left Atrium as an Active Component of the Pathophysiology in HCM

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