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Relationship between left atrial/left ventricular diameter ratio and outcomes in patients with hypertrophic

Keigo Kanbayashi1, Yuichiro Minami1, Shintaro Haruki1

  • 1Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.

Journal of Cardiology
|September 11, 2024
PubMed

Insights

The left atrial to left ventricular diameter ratio can predict hypertrophic cardiomyopathy (HCM) death risk. A higher ratio indicates a greater likelihood of HCM-related mortality, aiding in patient risk stratification.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Disease

Background:

  • Diastolic dysfunction is central to hypertrophic cardiomyopathy (HCM) pathophysiology.
  • The prognostic value of diastolic function parameters in HCM requires clarification.
  • Severe diastolic dysfunction in HCM often presents with left atrial (LA) dilation and a disproportionately small left ventricle (LV).

Purpose of the Study:

  • To investigate the relationship between the LA/LV diameter ratio and outcomes in patients with HCM.
  • To assess the LA/LV diameter ratio as a potential indicator of HCM disease progression and mortality.

Main Methods:

  • Echocardiographic evaluation of LA and LV end-diastolic diameters in 468 HCM patients.
  • Classification of patients into two groups based on LA/LV diameter ratio: >1 and ≤1.
  • Comparison of HCM-related death rates between the two groups.

Main Results:

  • A higher LA/LV diameter ratio (>1) was observed in 20.5% of patients.
  • Univariate analysis showed a significantly higher likelihood of HCM-related death in patients with an LA/LV ratio >1 (log-rank p=0.002).
  • Multivariate analysis identified an LA/LV diameter ratio >1 as an independent determinant of HCM-related death (adjusted hazard ratio: 1.87, p=0.024).

Conclusions:

  • The LA/LV diameter ratio is an easily measurable parameter.
  • This ratio may serve as a valuable tool for risk stratification of HCM-related death.
  • Utilizing the LA/LV diameter ratio can aid clinicians in identifying high-risk HCM patients.
Abstract

Keywords:
Diastolic dysfunctionEchocardiographyHypertrophic cardiomyopathyLeft atriumLeft ventricle

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