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. 2023 Feb 16:88:e103-e112.
doi: 10.5114/pjr.2023.125213. eCollection 2023.

The association of left atrial mechanics with left ventricular morphology in patients with hypertrophic cardiomyopathy: a cardiac magnetic resonance study

Arda Guler  1 , Cagdas Topel  2 , Ahmet Anil Sahin  3 , Sinem Aydin  4 , Ekrem Guler  5 , Kadriye Memic Sancar  1 , Aysel Turkvatan Cansever  4 , Gamze Babur Guler  1 , Mehmet Erturk  1
Affiliations

The association of left atrial mechanics with left ventricular morphology in patients with hypertrophic cardiomyopathy: a cardiac magnetic resonance study

Arda Guler et al. Pol J Radiol. .

Abstract

Purpose: Hypertrophic cardiomyopathy (HCM) is related with structural and pathologic changes in the left atrium (LA) and left ventricle (LV). The aim of this study was to explore the association between LA mechanics and LV characteristics in patients with HCM using cardiac magnetic resonance feature tracking (CMR-FT).

Material and methods: A total of 76 patients with HCM and 26 healthy controls were included in the study. The parameters including the extent of LV late gadolinium enhancement (LGE-%) and the LV early diastolic longitudinal strain rate (edLSR) were assessed for LV. LA conduit, booster, and reservoir functions were assessed by LA fractional volumes and strain analyses using CMR-FT. HCM patients were classified as HCM patients without LGE, with mild LGE-% (0% < LGE-% ł 10%), and prominent LGE-% (10% < LGE-%).

Results: HCM patients had worse LA functions compared with the controls (p < 0.05). The majority of LA functional indices were more impaired in HCM patients with regard to LGE. LA volumes were higher in HCM patients with prominent LGE-% compared with HCM patients with mild LGE-% (p < 0.05). However, only a minority of LA functional parameters differed between the 2 groups. LA strain parameters showed weak to modest correlations with LV LGE-% and LV edLSR.

Conclusions: LV characteristics, to some extent, influence LA mechanics, but they might not be the only factor inducing LA dysfunction in patients with HCM.

Keywords: cardiac magnetic resonance; hypertrophic cardiomyopathy; late gadolinium enhancement; left atrium.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
The flowchart of the patient selection
Figure 2
Figure 2
An asymmetric hypertrophic cardiomyopathy patient with focal late gadolinium enhancement on short-axis late gadolinium enhancement (LGE) image. A) The observer manually drew endocardial (red circle) and epicardial (green circle) areas of the myocardium. B) The software automatically identified the areas above the mean signal intensity plus 6 standard deviations of the normal-appearing myocardium. Then the LGE positive areas were proportioned the total myocardial area for each slice to quantify the extent of LGE
Figure 3
Figure 3
An illustration of left ventricular strain analysis. The observer manually traced the endocardial and epicardial borders of the left ventricle (LV) on the short-axis, 4-chamber (not shown), and 2-chamber (now shown) cine images at the end-diastole as the reference. Then the software automatically propagated the contours of the myocardium. LV early diastolic longitudinal strain rate (edLSR) was calculated on the 4-chamber image
Figure 4
Figure 4
An illustration of left atrial strain analysis. The observer manually traced the endocardial and epicardial borders of the left-atrium on the 4-chamber and 2-chamber cine images at the end-diastole as the reference. Then the software automatically propagated the contours of the myocardium through the cardiac cycle. For each patient, left atrial reservoir strain, conduit strain, and booster strain were calculated. Accordingly, reservoir SR, conduit SR, and booster SR were calculated for each patient
See this image and copyright information in PMC

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