1887
  1. Home
  2. A-Z Publications
  3. Global Cardiology Science and Practice
  4. Volume 2012, Issue 2
  5. Article
Volume 2012, Issue 2
  • ISSN: 2305-7823
  • EISSN:

Abstract

Abstract

Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We assessed the global and regional left atrial (LA) function and its relation to left ventricular (LV) mechanics and clinical status in patients with HCM using Vector Velocity Imaging (VVI).

VVI of the LA and LV was acquired from apical four- and two-chamber views of 108 HCM patients (age 40 ± 19years, 56.5% men) and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ϵ)/strain rate (SR) measurements.

Left atrial reservoir (ϵ,SR) and conduit (early diastolic SR) function were significantly reduced in HCM compared to controls (P < .0001). Left atrial deformation directly correlated to LVϵ, SR and negatively correlated to age, NYHA class, left ventricular outflow tract (LVOT) gradient, left ventricular mass index (LVMI), LA volume index and severity of mitral regurge (P < 0.001). Receiver operating characterist was constructed to explore the cutoff value of LA deformation in differentiation of LA dysfunction; ϵ < 40% was 75% sensitive, 50% specific, SR < 1.7s− 1 was 70% sensitive, 61% specific, SR> − 1.8s− 1 was 81% sensitive and 30% specific, SR> − 1.5s− 1 was 73% sensitive and 40% specific. By multivariate analysis global LVϵ and LV septal thickness are independent predictors for LAϵ, while end systolic diameter is the only independent predictor for SR, P < .001.

Left atrial reservoir and conduit function as measured by VVI were significantly impaired while contractile function was preserved among HCM patients. Left atrial deformation was greatly influenced by LV mechanics and correlated to severity of phenotype.

© 2012 Badran, Soltan, Hassan, Nazmy, Faheem, Saadan, Yacoub, licensee Bloomsbury Qatar Foundation Journals.
Loading

Article metrics loading...

/content/journals/10.5339/gcsp.2012.25
2013-12-01
2024-11-13
Loading full text...

Full text loading...

/deliver/fulltext/gcsp/2012/2/gcsp.2012.25.html?itemId=/content/journals/10.5339/gcsp.2012.25&mimeType=html&fmt=ahah

References

  1. BJ Maron. Hypertrophic cardiomyopathy: a systematic review. JAMA. 2002; 287::1308–20
     [Google Scholar]
  2. BJ Maron, WJ McKenna, GK Danielson, LJ Kappenberger, HJ Kuhn, CE Seidman, et al.. ACC/ESC Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy. A report of the ACC Foundation. Task Force on Clinical Expert Consensus Documents and ESC Committee for Practice Guidelines. Eur Heart J. 2003; 24::1965–91
     [Google Scholar]
  3. MA Losi, S Nistri, M Galderisi, S Betocchi, F Cecchi, I Olivotto, E Agricola, P Ballo, S Buralli, A D'Andrea, A D'Errico, D Mele, S Sciomer, S Mondillo. Echocardiography in patients with hypertrophic cardiomyopathy: usefulness of old and new techniques in the diagnosis and pathophysiological assessment. Cardiovasc Ultrasound. 2010 Mar 17 :8–7
     [Google Scholar]
  4. SR Ommen. Echocardiographic assessment of diastolic function. Curr Opin Cardiol. 2001; 16::240–5
     [Google Scholar]
  5. TS Tsang, ME Barnes, BJ Gersh, KR Bailey, JB Seward. Left atrial volume as a morphophysiologic expression of left ventricular diastolic dysfunction and relation to cardiovascular risk burden. Am J Cardiol. 2002; 90::1284–9
     [Google Scholar]
  6. G Perk, PA Tunick, I Kronzon. Non-Doppler two-dimensional strain imaging by echocardiography —from technical considerations to clinical applications. J Am Soc Echocardiogr. 2007; 20::234–43
     [Google Scholar]
  7. C Sirbu, L Herbots, J D'hooge, P Claus, A Marciniak, T Langeland, et al.. Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur J Echocardiogr. 2006; 7::199–208
     [Google Scholar]
  8. B Pirat, DS Khoury, CJ Hartley, L Tiller, L Rao, DG Schulz, et al.. A novel feature-tracking echocardiographic method for the quantitation of regional myocardial function: validation in an animal model of ischemia–reperfusion. J Am Coll Cardiol. 2008; 51::651–9
     [Google Scholar]
  9. MA Vannan, G Pedrizzetti, P Li, S Gurudevan, H Houle, J Main, et al.. Effect of cardiac resynchronization therapy on longitudinal and circumferential left ventricular mechanics by velocity vector imaging: description and initial clinical application of a novel method using high-frame rate B-mode echocardiographic images. Echocardiography. 2005; 22: 10: 826–30
     [Google Scholar]
  10. C Bussadori, A Moreo, M Di Donato, B De Chiara, D Negura, E Dall'Aglio, et al.. A new 2D-based method for myocardial velocity strain and strain rate quantification in a normal adult and paediatric population: assessment of reference values. Cardiovascular Ultrasound. 2009; 7::8
     [Google Scholar]
  11. T Ishikawa. Limitations and problems of assessment of mechanical dyssynchrony in determining cardiac resynchronization therapy indication. Is assessment of mechanical dyssynchrony necessary in determining CRT indication?. (Con). Circ J. 2011 Feb; 75: 2: 465–71Epub 2011 Jan 8
     [Google Scholar]
  12. D Mele, G Pasanisi, F Capasso, A De Simone, MA Morales, D Poggio, et al.. Left intra ventricular myocardial deformation dyssynchrony identifies responders to cardiac resynchronization therapy in patients with heart failure. Eur Heart J. 2006; 27::1070–78
     [Google Scholar]
  13. C Jarnert, A Melcher, K Caidahl, H Persson, L Ryde'n, MJ Eriksson. Left atrial velocity vector imaging for the detection and quantification of left ventricular diastolic function in type 2 diabetes. Eur J Heart Fail. 2008; 10::1080–87
     [Google Scholar]
  14. MV Burri, NC Nanda, SG Lloyd, MC Hsiung, HS Dod, RJ Beto, et al.. Assessment of systolic and diastolic left ventricular and left atrial function using vector velocity imaging in Takotsubo cardiomyopathy. Echocardiography. 2008; 25::1138–44
     [Google Scholar]
  15. K Okamatsu, M Takeuchi, H Nakai, T Nishikage, IS Salgo, S Husson, et al.. Effects of aging on left atrial function assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogr. 2009; 22::70–5
     [Google Scholar]
  16. AN Borg, KA Pearce, SG Williams, SG Ray. Left atrial function and deformation in chronic primary mitral regurgitation. Eur J Echocardiogr. 2009; 10::833–40
     [Google Scholar]
  17. P Barbier, SB Solomon, NB Schiller, SA Glantz. Left atrial relaxation and left ventricular systolic function determine left atrial reservoir function. Circulation. 1999; 100::427–36
     [Google Scholar]
  18. A Prioli, P Marino, L Lanzoni, P Zardini. Increasing degrees of left ventricular filling impairment modulate left atrial function in humans. Am J Cardiol. 1998; 82::756–61
     [Google Scholar]
  19. Y Inaba, S Yuda, N Kobayashi, A Hashimoto, K Uno, T Nakata, et al.. Strain rate imaging for noninvasive functional quantification of the left atrium: comparative studies in controls and patients with atrial fibrillation. J Am Soc Echocardiogr. 2005; 18::729–36
     [Google Scholar]
  20. T Wang, M Wang, JW Fung, GW Yip, Y Zhang, PP Ho, et al.. Atrial strain rate echocardiography can predict success or failure of cardioversion for atrial fibrillation: a combined transthoracic tissue Doppler and transesophageal imaging study. Int J Cardiol. 2007; 114::202–9
     [Google Scholar]
  21. N Kokubu, S Yuda, K Tsuchihashi, A Hashimoto, T Nakata, T Miura, et al.. Noninvasive assessment of left atrial function by strain rate imaging in patients with hypertension: a possible beneficial effect of Renin-Angiotensin system inhibition on left atrial function. Hypertens Res. 2007; 30::13–21
     [Google Scholar]
  22. SE Moustafa, M Alharthi, M Kansal, Y Deng, K Chandrasekaran1, F Mookadam1. Global left atrial dysfunction and regional heterogeneity in primary chronic mitral insufficiency. Eur J Echocardiogr. 2011; 12: 5: 384–93
     [Google Scholar]
  23. E Donal, P Raud-Raynier, A Racaud, D Coisne, D Herpin. Quantitative regional analysis of left atrial function by Doppler tissue imaging derived parameters discriminates patients with posterior and anterior myocardial infarction. J Am Soc Echocardiogr. 2005; 18::32–8
     [Google Scholar]
  24. T Le Tourneau, D Messika-Zeitoun, A Russo, D Detaint, Y Topilsky, DW Mahoney, et al.. Impact of left atrial volume on clinical outcome in organic mitral regurgitation. J Am Coll Cardiol. 2010; 56::570–8
     [Google Scholar]
  25. W Anne', R Willems, T Roskams, P Sergeant, P Herijgers, P Holemans, et al.. Matrix metalloproteinases and atrial remodeling in patients with mitral valve disease and atrial fibrillation. Cardiovasc Res. 2005; 67::655–66
     [Google Scholar]
  26. S Verheule, E Wilson, T 4th Everett, S Shanbhag, C Golden, J Olgin. Alterations in atrial electrophysiology and tissue structure in a canine model of chronic atrial dilatation due to mitral regurgitation. Circulation. 2003; 107::2615–22
     [Google Scholar]
  27. IA Paraskevaidis, F Panou, C Papadopoulos, D Farmakis, J Parissis, I Ikonomidis, et al.. Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: a tissue Doppler imaging and two-dimensional strain study. Heart. 2009 Mar; 95: 6: 483–9. Epub 2008 Sep 2
     [Google Scholar]
  28. MS Shin, BR Kim, KJ Oh, JM Bong, WJ Chung, WC Kang, et al.. Echocardiographic assessments of left atrial strain and volume in healthy patients and patients with mitral valvular heart disease by tissue Doppler imaging and 3-dimensional echocardiography. Korean Circ J. 2009; 39::280–7
     [Google Scholar]
  29. C Stefanadis, J Dernellis, C Stratos, E Tsiamis, C Vlachopoulos, K Toutouzas, et al.. Effects of balloon mitral valvuloplasty on left atrial function in mitral stenosis as assessed by pressure-area relation. J Am Coll Cardiol. 1998; 32::159–68
     [Google Scholar]
  30. SS Kuppahally, N Akoum, NS Burgon, TJ Badger, EG Kholmovski, S Vijayakumar, et al.. Left atrial strain and strain rate in patients with paroxysmal and persistent atrial fibrillation: relationship to left atrial structural remodeling detected by delayed-enhancement MRI. Circ Cardiovasc Imaging. 2010 May; 3: 3: 231–9. –Epub 2010 Feb4.
    [Google Scholar]
  31. A D'Andrea, G De Corato, R Scarafile, S Romano, L Reigler, C Mita, et al.. Left atrial myocardial function in either physiological or pathological left ventricular hypertrophy: a two-dimensional speckle strain study. Br J Sports Med. 2008 Aug; 42: 8: 696–702Epub 2007 Dec 10
     [Google Scholar]
  32. M Roşca, BA Popescu, CC Beladan, A Călin, D Muraru, EC Popa, et al.. Left atrial dysfunction as a correlate of heart failure symptoms in hypertrophic cardiomyopathy. J Am Soc Echocardiogr. 2010 Oct; 23: 10: 1090–98Epub 2010 Aug 23
     [Google Scholar]
  33. MS Shin, S Fukuda, JM Song, H Tran, S Oryszak, JD Thomas, et al.. Relationship between left atrial and left ventricular function in hypertrophic cardiomyopathy: a real-time 3-dimensional echocardiographic study. J Am Soc Echocardiogr. 2006 Jun; 19: 6: 796–801
     [Google Scholar]
  34. I El-Hamamsy, K Lekadir, L Olivotto, A El Guindy, R Merrifield, L Rega, G Yang, F Cecchi, MH Yacoub. Pattern and degree of left ventricular remodeling following a tailored surgical approach for hypertrophic obstructive cardiomyopathy. Global Cardiology Science and Practice. 2012 July :9
     [Google Scholar]
/content/journals/10.5339/gcsp.2012.25
Loading
Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging
Global Cardiology Science and Practice 2012, 25 (2013); https://doi.org/10.5339/gcsp.2012.25
/content/journals/10.5339/gcsp.2012.25
/content/journals/10.5339/gcsp.2012.25
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): hypertrophic cardiomyopathy, left atrial deformation and vector velocity imaging
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error