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In patients with hypertrophic cardiomyopathy myocardial fibrosis is associated with both left ventricular and left

Christian Prinz1, Frank Van Buuren, Nicola Bogunovic

  • 1Dept. of Cardiology, Heart and Diabetes Centre North-Rhine Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany. Cchrprinz@aol.com

Acta Cardiologica
|May 31, 2012
PubMed

Insights

Myocardial fibrosis in hypertrophic cardiomyopathy is linked to impaired left atrial and ventricular function. This dysfunction correlates with more severe heart failure symptoms, highlighting fibrosis as a key indicator of disease progression.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Cardiac Physiology

Background:

  • Hypertrophic cardiomyopathy (HCM) is a genetic heart muscle disease characterized by left ventricular hypertrophy.
  • Myocardial fibrosis, the deposition of collagen in the heart muscle, is a common finding in HCM and is associated with adverse outcomes.
  • Left atrial (LA) function plays a crucial role in diastolic filling and overall cardiac performance.

Purpose of the Study:

  • To evaluate left atrial (LA) function using two-dimensional speckle-tracking echocardiography (2DSTE).
  • To investigate the relationship between LA function and myocardial fibrosis in patients with hypertrophic cardiomyopathy (HCM).

Main Methods:

  • 30 HCM patients underwent 2DSTE to assess global longitudinal left ventricular (LV) strain and LA strain/strain-rate parameters.
  • Delayed-enhancement magnetic resonance imaging (DE-MRI) was used to detect and quantify myocardial fibrosis.
  • Patients were categorized into two groups: no fibrosis and moderate-to-severe fibrosis in at least two LV segments.

Main Results:

  • 20 patients (66.7%) exhibited moderate or severe myocardial fibrosis.
  • Patients with fibrosis showed significantly reduced global longitudinal LV strain and peak LA strain compared to those without fibrosis.
  • Increased indexed LA volume and higher New York Heart Association (NYHA) class were observed in patients with significant fibrosis, correlating with impaired LA and LV function.

Conclusions:

  • Myocardial fibrosis in HCM is associated with impaired left atrial and left ventricular function.
  • The presence and extent of fibrosis correlate with the severity of heart failure symptoms (NYHA class).
  • 2DSTE is a valuable tool for assessing LA dysfunction in the context of HCM-related myocardial fibrosis.
Abstract

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