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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left atrial phasic volumes are modulated by the type rather than the extent of left ventricular hypertrophy

Suzanne Eshoo1, Chris Semsarian, David L Ross

  • 1Westmead Hospital, University of Sydney, Sydney, Australia. suzanne.eshoo@sswahs.nsw.gov.au

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|March 16, 2010
PubMed

Insights

Patients with hypertrophic cardiomyopathy (HCM) exhibit larger left atrial (LA) volumes and impaired LA function compared to hypertension patients with similar left ventricular (LV) mass, suggesting coexistent atrial myopathy in HCM.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Electrophysiology

Background:

  • Left atrial (LA) enlargement is observed in hypertrophic cardiomyopathy (HCM) and hypertension (HT).
  • Both conditions cause left ventricular (LV) hypertrophy, necessitating comparison of LA alterations in HCM versus HT with similar LV mass.

Purpose of the Study:

  • To compare maximal LA volume and phasic atrial function in patients with HCM versus patients with HT and normal controls, matched for LV mass.

Main Methods:

  • Echocardiographic evaluation of maximal, minimal, and pre-atrial contraction LA volumes in 35 HCM patients, matched HT patients, and age/gender-matched controls.
  • Assessment of LA phasic function using LA ejection force, atrial fraction, and A' velocity.

Main Results:

  • HCM patients showed significantly increased maximal, minimal, and pre-atrial contraction LA volumes compared to HT and control groups.
  • LA conduit volume and emptying fractions (total, passive, active) were reduced in HCM patients.
  • HCM group exhibited a higher prevalence of abnormal diastolic filling (60% vs. 34%) despite comparable LV mass.

Conclusions:

  • Patients with HCM present with larger LA volumes, diminished LA function, and more severe diastolic dysfunction than HT patients with similar LV mass.
  • These LA alterations in HCM may stem from an associated atrial myopathy, potentially linked to outflow obstruction, mitral regurgitation, and myocardial fibrosis.
Abstract

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