Prognostic value of left atrial function by cardiovascular magnetic resonance feature tracking in hypertrophic cardiomyopathy

Hinojar, Rocío; Zamorano, José Luís; Fernandez-Mendez, M A; Esteban, Amparo Cano; Plaza-Martin, Maria; González-Gómez, A; Carbonell, Alejandra; Rincón, Luis Miguel; Nacher, J J Jimenez; Fernández-Golfín, Covadonga

doi:10.1007/s10554-019-01534-8

Cited by 55 publications

(63 citation statements)

References 41 publications

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“…Multiple investigations have shown that left atrial function provides important insight into the adaptive changes that contribute to ventricular filling 9‐17 . This investigation sought to assess left atrial function in INOCA, to expand our pathophysiologic understanding of progression to heart failure in this patient cohort.…”

Section: Discussionmentioning

confidence: 99%

“…The left atrium also contributes in generating the transmitral pressure gradient needed to fill the ventricle, and multiple investigations have shown that left atrial function provides important insight into the adaptive changes that contribute to ventricular filling. [9][10][11][12][13][14][15][16][17] To the best of our knowledge, no study has evaluated left atrial function in women with INOCA. Given that left atrial function is often impaired in HFpEF, 16,[18][19][20][21] we hypothesized that left atrial function would also be impaired in INOCA.…”

Section: Introductionmentioning

confidence: 99%

“…Consistent with the HFpEF phenotype, our group has shown that women with INOCA often have left ventricular diastolic dysfunction 5‐8 ; however, these investigations have focused almost exclusively on left ventricular relaxation. The left atrium also contributes in generating the transmitral pressure gradient needed to fill the ventricle, and multiple investigations have shown that left atrial function provides important insight into the adaptive changes that contribute to ventricular filling 9‐17 . To the best of our knowledge, no study has evaluated left atrial function in women with INOCA.…”

Section: Introductionmentioning

confidence: 99%

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Left atrial stiffness in women with ischemia and no obstructive coronary artery disease: Novel insight from left atrial feature tracking

Zamani

Samuel

Wei

et al. 2020

Clinical Cardiology

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Background Women with signs and symptoms of ischemia and no obstructive coronary artery disease (INOCA) are at risk of heart failure with preserved ejection fraction (HFpEF); however, the mechanism for HFpEF progression remains unclear. Studies in INOCA have largely focused on left ventricular function. The left atrium serves an important role in maintaining transmitral flow, and is impaired in HFpEF; however, it remains unclear if left atrial function is impaired in INOCA. Hypothesis Left atrial function is progressively worse in INOCA and HFpEF compared to controls. Methods We compared 39 reference control subjects to 64 women with INOCA and 22 subjects with HFpEF. Left atrial strain was assessed by feature tracking using magnetic resonance cine images. Results Peak left atrial strain was reduced in HFpEF compared to controls (22.9 ± 4.8% vs 25.9 ± 3.2%, P < .01), but similar in INOCA (24.8 ± 4.5%) compared to HFpEF and controls (P = .18). However, left ventricular end‐diastolic pressure (LVEDP) was elevated in 33% of INOCA participants, suggesting that left atrial stiffness (LVEDP/LA strain) is elevated in a large portion of women with INOCA. Conclusions Taken together, we interpret these data to support our working hypothesis that INOCA is a pre‐HFpEF state, with left atrial stiffness preceding overt left atrial dysfunction; representing a putative therapeutic target to prevent HFpEF progression in this at‐risk population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Left atrial stiffness in women with ischemia and no obstructive coronary artery disease: Novel insight from left atrial feature tracking

Zamani

Samuel

Wei

et al. 2020

Clinical Cardiology

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“…Left atrial fibrosis was found to correlate with the extent of LV LGE and LV strain in patients with hypertrophic cardiomyopathy [73]. The prognostic value of left atrial function assessed with CMR feature tracking was examined in patients with hypertrophic cardiomyopathy [74].…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging

Reiber

Pereira

Dallan

et al. 2020

Int J Cardiovasc Imaging

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“…[4] Recent studies also showed that LA function measured by strain imaging is an independent predictor of poor outcome in patients with HCM. [1,2] However, it has been reported that in HCM, LA dysfunction can occur as a myopathic process itself, irrespective of loading conditions. [4,5] In this regard, genetic contribution to LA structural and functional remodeling has not been well investigated.…”

Section: Introductionmentioning

confidence: 99%

Contribution of Sarcomere Gene Mutations to Left Atrial Function in Patients With Hypertrophic Cardiomyopathy

Chung

Kim

Park

et al. 2020

Preprint

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Background: Left atrial (LA) enlargement and dysfunction are related to clinical course in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate genetic contribution to LA structural and functional remodeling.Methods: 212 patients were consecutively enrolled, and echocardiography and extensive genetic analysis were performed. Cardiac magnetic resonance (CMR) was performed in 135 patients. Echocardiography was also performed in controls (n=30). Results: Patients with HCM had lower late-diastolic mitral annular velocity (a’) and higher LA volume index (LAVI) than controls. Patients with pathogenic or likely pathogenic sarcomere gene mutations (PSM, n = 67, 32%) had higher LAVI and lower CMR-derived LA total emptying fraction (37.0 ± 18.5 vs. 44.2 ± 12.4%, p=0.025). In patients without AF (n = 187), the PSM had lower a’ (6.9 ± 2.0 vs. 7.8 ± 1.9 cm/s, p = 0.004) than others. The PSM had higher prevalence and amount of late gadolinium enhancement (LGE) in the left ventricle (LV). In multivariate analysis, PSM was significantly related to lower a’ independent of E/e’, LV mass index, and LAVI. However, the relation significantly attenuated after adjustment for the extent of LGE in the LV, suggesting common myopathy in the LV and LA.Conclusions: PSM was related to LA dysfunction independent of LV filling pressure and LAVI, suggesting its contribution to atrial myopathy in HCM.

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Prognostic value of left atrial function by cardiovascular magnetic resonance feature tracking in hypertrophic cardiomyopathy

Cited by 55 publications

References 41 publications

Left atrial stiffness in women with ischemia and no obstructive coronary artery disease: Novel insight from left atrial feature tracking

Left atrial stiffness in women with ischemia and no obstructive coronary artery disease: Novel insight from left atrial feature tracking

Cardiovascular imaging 2019 in the International Journal of Cardiovascular Imaging

Contribution of Sarcomere Gene Mutations to Left Atrial Function in Patients With Hypertrophic Cardiomyopathy

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