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Correlation between left ventricular hypertrophy, myocardial fibrosis, and left atrial function in non-obstructive

Yan Zheng1,2, Ma Liyuan2, Qian Wu1,2

  • 1Department of Radiology, General Hospital of Ningxia Medical University, Yichuan, 750004, China.

The International Journal of Cardiovascular Imaging
|March 29, 2025
PubMed

Insights

Cardiac magnetic resonance imaging reveals that left ventricular fibrosis in nonobstructive hypertrophic cardiomyopathy significantly impairs left atrial function, even in early stages. This imaging technique aids in early detection and risk stratification for NOHCM patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Nonobstructive hypertrophic cardiomyopathy (NOHCM) is characterized by left ventricular (LV) hypertrophy and myocardial fibrosis.
  • These pathological changes progressively impair left atrial (LA) function, impacting overall cardiac performance.

Purpose of the Study:

  • To evaluate the impact of LV hypertrophy and fibrosis on LA dysfunction in NOHCM patients.
  • To assess the utility of cardiac magnetic resonance (CMR) imaging with feature-tracking (FT) strain analysis in detecting LA dysfunction.

Main Methods:

  • Ninety-nine NOHCM patients were stratified into four groups based on late gadolinium enhancement (LGE) indicating fibrosis extent.
  • LA functional parameters (reservoir, conduit, pump strain) were analyzed using CMR-FT strain analysis.
  • LV morphological and functional indices were correlated with LA strain metrics.

Main Results:

  • LA functional parameters significantly decreased with increasing LGE burden (P < 0.05).
  • Reduced LA function was detectable even in mild fibrosis cases, despite preserved LV ejection fraction.
  • LV indices (GPWT, LVESV, LGE%) negatively correlated with LA strain metrics (r = -0.2 to -0.7, P < 0.05).
  • CMR-FT strain analysis demonstrated high reproducibility (ICC > 0.75).

Conclusions:

  • CMR-FT is a sensitive and reliable tool for early detection of LA dysfunction in NOHCM.
  • Subtle changes in LA mechanics identified by CMR-FT can provide insights for risk stratification.
  • Early detection of LA dysfunction can guide interventions to improve clinical outcomes in NOHCM patients.

Keywords:
Cardiac magnetic resonance imaging (CMR)Hypertrophic cardiomyopathyLate gadolinium enhancement (LGE)Left atrial functionMyocardial fibrosis

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