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Characteristics of Left Atrial Deformation Parameters and Their Prognostic Impact in Patients with Pathological Left Ventricular Hypertrophy: Analysis by Speckle Tracking Echocardiography
Author(s) -
Iio Chiharuko,
Inoue Katsuji,
Nishimura Kazuhisa,
Fujii Akira,
Nagai Takayuki,
Suzuki Jun,
Okura Takafumi,
Higaki Jitsuo,
Ogimoto Akiyoshi
Publication year - 2015
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12961
Subject(s) - cardiology , medicine , atrial fibrillation , speckle tracking echocardiography , left ventricular hypertrophy , heart failure , pathological , hypertensive heart disease , hypertrophic cardiomyopathy , cardiac amyloidosis , heart disease , ejection fraction , blood pressure
Background The pathological process of left ventricular ( LV ) hypertrophy is associated with left atrial ( LA ) remodeling. This study was aimed to evaluate the prognostic value of LA strain parameters in patients with pathological LV hypertrophy. Methods This study included 95 patients with hypertensive heart disease ( HHD : n = 24), hypertrophic cardiomyopathy ( HCM : n = 56), cardiac amyloidosis ( CA : n = 15), and control subjects (n = 20). We used two‐dimensional speckle tracking echocardiography ( STE ) to analyze LA global strain. LA electromechanical conduction time ( EMT ) at the septal ( EMT ‐septal) and lateral wall ( EMT ‐lateral), and their time difference ( EMT ‐diff) were calculated. The incidence of cardiac death and heart failure hospitalization was defined as major cardiac events and that of atrial fibrillation as secondary outcome. Results Left atrial volume index was increased and LA booster strain was decreased in the HCM and CA groups compared with the HHD group. EMT ‐lateral was increased in the diseased groups compared with the control. EMT ‐diff was prolonged in the CA group compared with the HCM group. During the follow‐up period (mean 3.4 years), major cardiac events and atrial fibrillation occurred in 17 and 13 patients, respectively. The occurrence of atrial fibrillation was associated with CA etiology, E/e′, LA volume index, LA a, and EMT ‐lateral. The incidence of major cardiac events was independently correlated with LA volume index and EMT ‐diff in multivariate analysis. Conclusion This study suggested that the EMT ‐diff could discriminate patients with a high risk of cardiac events among patients with pathological LV hypertrophy.