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Assessment of atrial function by myocardial deformation techniques in hypertrophic cardiomyopathy

Valerie Siam-Tsieu1, Sophie Urtado1, Philippe Charron2,3

  • 1Department of Cardiology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre de référence des cardiomyopathies et des troubles du rythme cardiaque héréditaires ou rares, Université de Versailles-Saint Quentin (UVSQ), Boulogne, France.

Echocardiography (Mount Kisco, N.Y.)
|December 31, 2020
PubMed

Insights

Assessing left atrial (LA) function in hypertrophic cardiomyopathy (HCM) using longitudinal strain is more reliable than conventional echocardiography for understanding patient symptoms. This method accurately identifies symptomatic individuals with HCM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Echocardiography

Background:

  • Diastolic dysfunction is common in hypertrophic cardiomyopathy (HCM).
  • Assessing diastolic dysfunction in HCM using conventional echocardiography presents challenges.
  • Left atrial (LA) function plays a crucial role in diastolic dysfunction.

Purpose of the Study:

  • To evaluate left atrial (LA) function in HCM patients using longitudinal strain analysis.
  • To determine the utility of LA longitudinal strain in understanding HCM-related symptoms.
  • To compare LA function assessment by longitudinal strain versus conventional echocardiography.

Main Methods:

  • Studied 144 patients: 48 with HCM, 48 controls, 48 athletes, matched for age and sex.
  • Assessed LA function using conventional echocardiography and longitudinal atrial strain parameters (LASr).
  • Analyzed correlations between LA strain parameters, peak VO2, and symptom severity (NYHA classification).

Main Results:

  • All longitudinal atrial strain parameters were significantly reduced in the HCM group compared to controls and athletes (P < .0001).
  • Left atrial strain reservoir (LASr) showed a significant correlation with peak VO2 (r=0.44, P=0.01).
  • LASr was the best parameter for detecting symptomatic HCM patients, with a cutoff of 15% (Sensitivity 71%, Specificity 79%).

Conclusions:

  • Longitudinal strain assessment of LA function is feasible in HCM.
  • LA longitudinal strain is more reliable than conventional echocardiography for understanding HCM symptom determinants.
  • This technique offers a valuable tool for evaluating patients with hypertrophic cardiomyopathy.
Abstract

Keywords:
atrial straindiastolic functionhypertrophic cardiomyopathymyocardial deformation techniques

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