Homeostatic Left Heart integration and disintegration links atrio-ventricular covariation's dyshomeostasis in Hypertrophic Cardiomyopathy

Area of Science:

• Cardiovascular Physiology
• Biomedical Engineering
• Cardiac Mechanics

Background:

• Cardiovascular investigations traditionally analyze the left ventricle and left atrium separately.
• Echocardiography has advanced understanding of systolic-diastolic differences and chamber-specific impairments.
• Recent trajectory-based methods offer insights into individual chamber function in conditions like hypertrophic cardiomyopathy.

Purpose of the Study:

• To investigate the concomitant function and geometrical/mechanical relationship between the left ventricle and left atrium.
• To analyze the trajectory attributes of the entire left heart as a whole and the shape covariation of its subunits.
• To contrast these parameters in healthy subjects versus patients with hypertrophic cardiomyopathy.

Main Methods:

• Acquisition of synchronized left ventricle and left atrium geometries within the same heartbeat.
• Application of trajectory-based analysis to assess the entire left heart's motion and shape.
• Evaluation of shape covariation between the left ventricle and left atrium.

Main Results:

• Impairments in the left heart's overall trajectory, specifically in orientation and size, were observed.
• Significant differences in the direction of morphological covariation between the left ventricle and left atrium were identified.
• These findings highlight altered inter-chamber dynamics in hypertrophic cardiomyopathy.

Conclusions:

• The study provides the first analysis of the concomitant function of the left ventricle and left atrium as a unified system.
• Altered left heart trajectory and inter-chamber shape covariation offer new insights into hypertrophic cardiomyopathy pathophysiology.
• This approach enables a more comprehensive evaluation of cardiovascular diseases by considering the integrated function of the left heart chambers.