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Left atrial index is a predictor of exercise capacity in patients with hypertrophic cardiomyopathy

Jesper Kjaergaard1, Bruce D Johnson, Patricia A Pellikka

  • 1Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|December 27, 2005
PubMed

Insights

Left atrial enlargement is linked to reduced exercise capacity in hypertrophic cardiomyopathy (HCM) patients. Larger left atrial volume independently predicts lower exercise capacity in HCM, even without severe mitral regurgitation.

Area of Science:

  • Cardiology
  • Cardiovascular Research
  • Clinical Medicine

Background:

  • Left atrial (LA) enlargement is common in hypertrophic cardiomyopathy (HCM).
  • LA enlargement is associated with diastolic dysfunction and mitral regurgitation (MR).
  • The relationship between LA size and exercise capacity in HCM requires further investigation.

Purpose of the Study:

  • To investigate the association between left atrial (LA) size and exercise capacity in patients with hypertrophic cardiomyopathy (HCM).

Main Methods:

  • Retrospective analysis of HCM patients undergoing treadmill testing (VO2 measurement) and echocardiography (2001-2003).
  • Exercise capacity defined as % predicted peak VO2.
  • Comparison of HCM patients with normal subjects, excluding those with comorbidities.

Main Results:

  • HCM patients exhibited increased LA volume index and mitral E/e' ratio compared to controls.
  • LA volume index showed a borderline correlation with exercise capacity (P=.06).
  • LA volume index was an independent predictor of exercise capacity in multivariate analysis, alongside BMI, resting heart rate, and LV end-systolic diameter.

Conclusions:

  • Left atrial volume index is independently associated with exercise capacity in isolated HCM.
  • LA size reflects combined influences of MR and diastolic dysfunction on exercise capacity.
  • Mitral regurgitation severity or E/e' ratio did not add incremental predictive value beyond LA volume index.
Abstract

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