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Determinant of left atrial dilation in patients with hypertrophic cardiomyopathy: a real-time 3-dimensional

Fabrice Bauer1, Takahiro Shiota, Richard D White

  • 1Cleveland Clinic Foundation, Ohio 44195, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|September 1, 2004
PubMed

Insights

Left atrial dilation in hypertrophic obstructive cardiomyopathy (HOCM) is linked to elevated left ventricular (LV) filling pressures, LV outflow tract gradients, and LV wall thickness. Real-time 3D echocardiography accurately measures left atrial volume in HOCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Hypertrophic obstructive cardiomyopathy (HOCM) can lead to left atrial (LA) dilation.
  • Accurate assessment of LA volume is crucial for understanding HOCM pathophysiology.
  • Real-time 3D echocardiography offers potential for precise LA volume measurement.

Purpose of the Study:

  • To identify key determinants of left atrial (LA) dilation in patients with hypertrophic obstructive cardiomyopathy (HOCM).
  • To validate the accuracy of real-time 3-dimensional echocardiography for determining LA volume compared to magnetic resonance imaging.
  • To investigate the relationship between various hemodynamic and structural factors and LA dilation in HOCM.

Main Methods:

  • Validation of real-time 3D echocardiography for LA volume measurement against MRI.
  • Echocardiographic assessment (real-time 3D and 2D Doppler) in 60 HOCM patients and 17 controls.
  • Stepwise multilinear regression analysis to identify determinants of LA dilation.

Main Results:

  • Real-time 3D echocardiography accurately determined LA volume.
  • HOCM patients exhibited significantly higher LA volumes and LV filling pressures than controls.
  • LV end-diastolic pressure, resting LV outflow tract pressure gradient, and LV wall thickness were significant independent predictors of LA dilation.

Conclusions:

  • Real-time 3D echocardiography is a reliable method for quantifying LA volume in HOCM.
  • LA dilation in HOCM is primarily determined by elevated LV filling pressures, LV outflow tract gradients, and LV wall thickness.
  • Certain hemodynamic parameters like tau, -dP/dt, LV stiffness, and mitral regurgitation were not independently associated with LA volumes in this cohort.

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