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Characterization of left atrial geometry and function in patients with hypertrophic cardiomyopathy: a cardiac

I D Muresan1, A Zlibut, R-I Orzan

  • 1Department of Internal Medicine, Faculty of Medicine, Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. luciacoldea@yahoo.com.

European Review for Medical and Pharmacological Sciences
|July 1, 2022
PubMed

Insights

Cardiac magnetic resonance imaging reveals significant left atrial (LA) remodeling in hypertrophic cardiomyopathy (HCM) patients. Impaired LA function and increased LA volume are linked to disease severity and diastolic dysfunction.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Left atrial (LA) remodeling is a key pathological feature in hypertrophic cardiomyopathy (HCM), but its comprehensive evaluation remains incomplete.
  • Cardiac magnetic resonance imaging (cMRI) offers precise characterization of cardiac structure and function, making it ideal for assessing LA alterations.

Purpose of the Study:

  • To thoroughly assess left atrial (LA) remodeling using cardiac magnetic resonance imaging (cMRI) in patients with hypertrophic cardiomyopathy (HCM).
  • To evaluate the relationship between LA alterations and left ventricular (LV) function and diastolic dysfunction in HCM.

Main Methods:

  • 105 patients with HCM and 105 healthy controls underwent cMRI.
  • LA parameters including volume (LAV), total ejection fraction (LATF), total strain (LA-εt), passive ejection fraction (LAPF), passive strain (LA-εe), active ejection fraction (LAAF), active strain (LA-εa), sphericity index (LASI), and LA strain were measured.
  • LV systolic and diastolic functions were also assessed.

Main Results:

  • Patients with HCM showed significantly increased LAV and LASI, alongside decreased LA phasic functions (p<.001).
  • LATF was inversely correlated with LV long-axis strain, LV mass, and filling pressures (E/E').
  • LA volumes, geometry, and phasic functions were negatively associated with LV measurements; LAV correlated closely with diastolic dysfunction severity.

Conclusions:

  • All three LA phasic functions are impaired in HCM patients, directly correlating with LA enlargement.
  • LA sphericity index (LASI) and LA strain are predictive of impaired LA reservoir function in HCM.
  • cMRI provides a comprehensive assessment of LA remodeling in HCM, highlighting its association with disease severity and diastolic dysfunction.
Abstract

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