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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
Left atrial myocardial function in either physiological or pathological left ventricular hypertrophy: a
A D'Andrea1, G De Corato, R Scarafile
1Department of Cardiology, Second University of Naples, Naples 80121, Italy. adandrea@napoli.com
British Journal of Sports Medicine
|December 12, 2007
Summary
Left atrial (LA) myocardial function is impaired in hypertensive patients with left ventricular hypertrophy (LVH), as shown by two-dimensional strain echocardiography (2DSE). This impairment is linked to reduced functional capacity during exercise.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Physiology
Background:
- Atrial function is crucial for overall cardiac performance but often overlooked.
- Left ventricular hypertrophy (LVH), common in arterial hypertension, can negatively impact atrial function.
- Physical training may mitigate age-related declines in diastolic filling, suggesting a role for exercise in preserving cardiac function.
Purpose of the Study:
- To investigate mechanical dysfunction in the left atrium (LA) of patients with physiological or pathological LVH.
- To utilize two-dimensional strain echocardiography (2DSE) for assessing LA mechanical properties.
- To compare LA function in hypertensive patients, elite athletes, and healthy controls.
Main Methods:
- Echocardiography, including exercise stress echo and 2DSE of the LA, was performed on 40 hypertensive patients, 45 elite athletes, and 25 controls.
- Atrial longitudinal strain was measured from apical views of the LA septum, lateral wall, and roof.
- Analysis focused on comparing LA dimensions, volumes, and strain parameters across the study groups.
Main Results:
- While LV mass and ejection fraction were similar between physiological and pathological LVH groups, elite athletes had increased LV dimensions and stroke volume.
- Hypertensive patients exhibited higher LA active emptying volume and fraction, but reduced peak systolic myocardial atrial strain compared to controls and athletes.
- LV end-diastolic volume/BSA and LV mass were independent determinants of LA lateral wall strain in athletes, whereas LV mass and end-systolic stress were negatively associated in hypertensive patients.
Conclusions:
- 2DSE is a valuable, non-invasive tool for assessing LA myocardial function in patients with LVH.
- Hypertension-induced LVH is associated with impaired LA myocardial deformation compared to controls and athletes.
- LA myocardial strain is a significant predictor of functional capacity during exercise in patients with LVH.
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