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Updated: May 1, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Changes in left atrial deformation in hypertrophic cardiomyopathy: Evaluation by vector velocity imaging
Hala Mahfouz Badran, Ghada Soltan1, Hesham Hassan1
1Cardiology Department, Menoufiya University, Egypt.
Insights
Hypertrophic cardiomyopathy (HCM) impairs left atrial reservoir and conduit function, as shown by Vector Velocity Imaging (VVI). Atrial deformation is linked to left ventricular mechanics and disease severity in HCM patients.
Area of Science:
- Cardiology
- Medical Imaging
- Myocardial Diseases
Background:
- Hypertrophic cardiomyopathy (HCM) is a generalized myopathic process affecting atrial and ventricular myocardium.
- Understanding left atrial (LA) function is crucial in managing HCM.
- Vector Velocity Imaging (VVI) offers advanced assessment of cardiac mechanics.
Purpose of the Study:
- To assess global and regional LA function in HCM patients using VVI.
- To investigate the relationship between LA mechanics, left ventricular (LV) mechanics, and clinical status in HCM.
- To identify predictors of LA dysfunction in HCM.
Main Methods:
- VVI of LA and LV was performed in 108 HCM patients and 33 controls with normal LV systolic function.
- LA subendocardial tracing was used to measure atrial volumes, ejection fraction, velocities, and strain/strain rate.
- Correlation and multivariate analyses were employed to assess relationships and predictors.
Main Results:
- LA reservoir (ϵsys, SRsys) and conduit (SRe) function were significantly reduced in HCM patients compared to controls.
- LA deformation correlated with LV mechanics (ϵsys, SRsys), age, NYHA class, LVOT gradient, LVMI, LA volume index, and mitral regurgitation severity.
- Specific cutoff values for LA strain and strain rate were identified for differentiating LA dysfunction.
Conclusions:
- VVI revealed significantly impaired LA reservoir and conduit function in HCM patients, with preserved contractile function.
- LA deformation is substantially influenced by LV mechanics and correlates with the severity of the HCM phenotype.
- VVI is a valuable tool for assessing LA function and its relationship to LV mechanics in HCM.
Objectives:
Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We assessed the global and regional left atrial (LA) function and its relation to left ventricular (LV) mechanics and clinical status in patients with HCM using Vector Velocity Imaging (VVI).
Methods:
VVI of the LA and LV was acquired from apical four- and two-chamber views of 108 HCM patients (age 40 ± 19years, 56.5% men) and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ϵ)/strain rate (SR) measurements.
Results:
Left atrial reservoir (ϵsys,SRsys) and conduit (early diastolic SRe) function were significantly reduced in HCM compared to controls (P < .0001). Left atrial deformation directly correlated to LVϵsys, SRsys and negatively correlated to age, NYHA class, left ventricular outflow tract (LVOT) gradient, left ventricular mass index (LVMI), LA volume index and severity of mitral regurge (P < 0.001). Receiver operating characterist was constructed to explore the cutoff value of LA deformation in differentiation of LA dysfunction; ϵsys < 40% was 75% sensitive, 50% specific, SRsys < 1.7s(- 1) was 70% sensitive, 61% specific, SRe> - 1.8s(- 1) was 81% sensitive and 30% specific, SRa> - 1.5s(- 1) was 73% sensitive and 40% specific. By multivariate analysis global LVϵsys and LV septal thickness are independent predictors for LAϵsys, while end systolic diameter is the only independent predictor for SRsys, P < .001.
Conclusion:
Left atrial reservoir and conduit function as measured by VVI were significantly impaired while contractile function was preserved among HCM patients. Left atrial deformation was greatly influenced by LV mechanics and correlated to severity of phenotype.
