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Detection of Left Atrial Remodeling by Three-Dimensional Echocardiography in Symptomatic Patients Known to Had

Taher Said Abd Elkareem1,2, Shaimaa Habib3, Amr Shehata4

  • 1Department of Cardiology, Nizwa Hospital, Nizwa, Oman.

Cardiology Research
|October 18, 2024
PubMed

Insights

Hypertrophic cardiomyopathy (HCM) patients exhibit impaired left atrial (LA) function and increased LA volume. Three-dimensional echocardiography reveals adverse LA remodeling, highlighting its role in HCM assessment.

Area of Science:

  • Cardiology
  • Inherited cardiovascular diseases
  • Echocardiography

Background:

  • Hypertrophic cardiomyopathy (HCM) is a prevalent inherited heart disorder and a leading cause of sudden cardiac death.
  • Left atrial (LA) dilatation is common in HCM due to impaired left ventricular (LV) relaxation or direct LA myocardial involvement.

Purpose of the Study:

  • To assess left atrial (LA) remodeling and mechanics in patients with non-obstructive hypertrophic cardiomyopathy (HCM).
  • To evaluate the utility of three-dimensional (3D) echocardiography in characterizing LA abnormalities in HCM.

Main Methods:

  • Enrolled 170 patients with non-obstructive HCM and 30 healthy controls.
  • Performed two-dimensional (2D) and three-dimensional (3D) echocardiography to measure LV dimensions, function, LA dimensions, LA deformations, pulmonary artery pressure (PAP), and LV global longitudinal strain (LVGLS).
  • Utilized 3D speckle tracking echocardiography (STE) for detailed LA volume and mechanics assessment.

Main Results:

  • Patients with HCM showed significantly reduced LA reservoir, conduit, and booster pump functions compared to controls (P < 0.001).
  • HCM patients had higher pulmonary artery pressure (PAP) and lower LV global longitudinal strain (LVGLS).
  • 3D STE revealed significantly increased indexed maximum LA volume (Vmax indexed) and decreased LA strain (LASr, LAScd, LASct) in HCM patients (P < 0.001).

Conclusions:

  • Three-dimensional transthoracic echocardiography (TTE) is a feasible method for assessing LA remodeling in HCM.
  • Patients with long-standing non-obstructive HCM exhibit adverse LA remodeling, characterized by impaired LA mechanics and increased septal thickness.
  • Diastolic dysfunction and reduced LA mechanics are more pronounced with increased septal thickness in HCM.
Abstract

Keywords:
3D TTEHCMLA mechanicsLA strain

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