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Left atrial remodelling and function in various left ventricular hypertrophic phenotypes.

Martina De Raffele1,2, Albert Teis1, German Cediel3,4

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Left atrial remodeling differs across left ventricular hypertrophy types. Left atrioventricular coupling index and indexed LA volumes correlate with LA function, while LA sphericity relates to reservoir strain.

Keywords:
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Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Pathophysiology

Background:

  • Left ventricular (LV) hypertrophy's impact on left atrial (LA) remodeling and function is not fully understood.
  • Different etiologies of LV hypertrophy may lead to distinct patterns of LA changes.

Purpose of the Study:

  • To investigate how various hypertrophic phenotypes influence LA remodeling and function.
  • To identify correlations between LA characteristics and underlying LV pathology.

Main Methods:

  • Retrospective analysis of cardiac magnetic resonance (CMR) data from 375 individuals.
  • Comparison of patients with hypertrophic cardiomyopathy, cardiac amyloidosis, hypertensive heart disease, and aortic stenosis against controls.
  • Assessment of LA strain, volume, sphericity, and left atrioventricular coupling index (LACI).

Main Results:

  • Cardiac amyloidosis showed significantly larger indexed LA volumes and sphericity, and higher LACI compared to other groups.
  • Patients with cardiac amyloidosis had the lowest LA reservoir and booster strain.
  • LACI, indexed LA maximal volume, LA sphericity, and LV global longitudinal strain were independently correlated with various LA functional parameters.

Conclusions:

  • LA characteristics vary significantly among different LV hypertrophic phenotypes.
  • LACI and indexed LA volumes are key independent predictors of overall LA function.
  • LA sphericity is an independent correlate of LA reservoir strain.