Left atrial function and phenotypes in asymmetric hypertrophic cardiomyopathy

Yukari Kobayashi, Matthew Wheeler, Gherardo Finocchiaro, Miyuki Ariyama, Yuhei Kobayashi, Marco V. Perez, David Liang, Tatiana Kuznetsova, Ingela Schnittger, Euan Ashley, Francois Haddad

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background: Few studies have analyzed changes in left atrial (LA) function associated with different phenotypes of asymmetric hypertrophic cardiomyopathy (HCM). We sought to demonstrate the association of impairments in LA function with disease phenotype in patients with obstructive and nonobstructive HCM. Methods: From Stanford Cardiomyopathy Registry, we randomly selected 50 age-/sex-matched healthy controls, 35 patients with nonobstructive HCM (HCM 1), 35 patients with obstructive HCM (HCM 2), and 35 patients with obstructive HCM requiring septal reduction therapy (HCM 3). Echocardiography was performed to evaluate left ventricular (LV) strain as well as LA function including LA emptying fraction and LA strain. Results: The mean age was 51±14 years and 57% were male. LA volume index differed among all four predefined groups (25.6±6.7 mL/m2 in controls, 32.2±13.3 mL/m2 in HCM 1, 42.0±12.9 mL/m2 in HCM 2, 52.4±15.2 mL/m2 for HCM 3, and P<.05 all between groups). All measurement of LA function was impaired in patients with HCM than controls. Total and passive LA function was further impaired in HCM 2 or 3 compared with HCM 1, while active LA function was not different among the three groups. Among LV strains, only septal longitudinal strain differed among all groups (−18.5±1.9% in controls, −14.5±1.9% in HCM 1, −13.3±1.8% in HCM 2, −11.6±2.3% in HCM 3, and P<.05 all between groups). Conclusions: LA function was impaired in patients with HCM even in minimally symptomatic nonobstructive phenotype. Total and passive LA function was further impaired in patients with obstructive HCM.

Original languageEnglish (US)
Pages (from-to)843-850
Number of pages8
JournalEchocardiography
Volume34
Issue number6
DOIs
StatePublished - Jun 2017
Externally publishedYes

Keywords

  • atrial function
  • hypertrophic cardiomyopathy
  • strain imaging

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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