Three-dimensional speckle tracking echocardiography allows detailed evaluation of left atrial function in hypertrophic cardiomyopathy--insights from the MAGYAR-Path Study

Abstract

Introduction: Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. Reduced left atrial (LA) function was demonstrated in HCM by different methods. Three-dimensional (3D) speckle tracking echocardiography (STE) has just been introduced for the evaluation of LA. This study was designed to compare 3DSTE-derived LA volumetric and strain parameters in HCM with healthy controls.

Methods: The study comprised 23 consecutive HCM patients (mean age: 48.5 ± 15.1 years, 14 men). Their results were compared to 23 age- and gender-matched healthy controls. Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all cases.

Results: Calculated LA maximum (66.4 ± 20.4 mL vs. 36.0 ± 6.1 mL, P < 0.0001) and minimum (39.2 ± 19.1 vs. 16.0 ± 4.6 mL, P < 0.0001) volumes and LA volume before atrial contraction (53.6 ± 19.9 vs. 24.0 ± 6.2 mL, P < 0.0001) were significantly increased in HCM patients. Atrial stroke volumes respecting cardiac cycles proved to be increased, while emptying fractions were decreased in subjects with HCM. Mean global radial (-12.2 ± 6.7% vs. -19.6 ± 11.7, P < 0.05), longitudinal (26.5 ± 16.5% vs. 29.8 ± 12.1%, P < 0.05) and 3D strain (-6.1 ± 4.4% vs. -12.5 ± 10.2%, P < 0.05) proved to be significantly reduced in HCM patients as compared with matched controls.

Conclusions: Three-dimensional speckle tracking echocardiography allows detailed evaluation of LA (dys) function in HCM by volumetric and strain measurements.

Keywords: echocardiography; function; hypertrophic cardiomyopathy; left atrium; speckle tracking; three-dimensional.