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Incremental value of left atrial active function measured by speckle tracking echocardiography in patients with hypertrophic cardiomyopathy
Author(s) -
Fujimoto Kaori,
Inoue Katsuji,
Saito Makoto,
Higashi Haruhiko,
Kono Tamami,
Uetani Teruyoshi,
Aono Jun,
Nagai Takayuki,
Nishimura Kazuhisa,
Suzuki Jun,
Okura Takafumi,
Ikeda Shuntaro,
Nakatani Satoshi,
Higaki Jitsuo
Publication year - 2018
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.13886
Subject(s) - cardiology , medicine , hypertrophic cardiomyopathy , speckle tracking echocardiography , atrial fibrillation , diastole , cardiomyopathy , ventricle , doppler echocardiography , heart failure , ejection fraction , blood pressure
Purpose Hypertrophic cardiomyopathy ( HCM ) impairs left ventricular ( LV ) diastolic function leading to left atrial ( LA ) dilatation. Because Doppler echocardiography cannot accurately assess LV diastolic function in hearts with heterogeneous hypertrophy, assessment of LA function might be useful for risk stratification of patients with HCM . This study aimed to elucidate the impact of LA function on outcome in patients with patients. Methods Seventy‐six patients with HCM who underwent echocardiographic and cardiac magnetic resonance imaging were retrospectively enrolled. Twenty‐six control subjects were also included. Using speckle tracking echocardiography, LA function was divided into active and passive strain indices based on the timing of the second positive peak of LA strain rate that occurred during LV systole. Results Left atrial strain indices of active and passive function were significantly impaired concomitantly with increased LA volume index in HCM patients compared with controls. During follow‐up (2.6 ± 1.7 years), 14 patients with HCM developed cardiac events (heart failure hospitalization or atrial fibrillation). The association of LA active strain with cardiac events was independent of and incremental to clinical and echocardiographic parameters (age, gender, E/e′, LV global longitudinal strain, and LA volume index) in sequential models. Cardiac events were more frequent in HCM patients with LA active strain <20.3% than with active strain ≥20.3% ( P = .01). Conclusion Loss of LA active function was associated with increased cardiac events in patients with HCM .