Key result
Hypertrophic cardiomyopathy patients had significantly higher left atrial mass (89.8 g vs 32.3 g) and augmented left atrial pump function compared to normal controls.
Why the study?
How does hypertrophic cardiomyopathy affect left atrial volume, mass, and function compared to controls as measured by two-dimensional echocardiography?
Case-Control (n=50)
How does hypertrophic cardiomyopathy affect left atrial volume, mass, and function compared to controls as measured by two-dimensional echocardiography?
Hypertrophic cardiomyopathy is associated with increased left atrial size and augmented pump function, while conduit and reservoir functions are impaired specifically in the obstructive subtype.
Should not change hypertrophic cardiomyopathy management; leaves open whether left atrial parameters improve risk stratification.
METHODS: The study included 25 hypertrophic cardiomyopathy (HCM) patients (15 non-obstructive and 10 obstructive) and 25 controls for assessment of left atrial (LA) volume, mass and function by two-dimensional echocardiography. Measurement included mean LA diameter (LAD), LA mass = {(mean LAD + anterior LA wall + posterior LA wall)3 - mean LAD3} x 0.8 + 0.6, LA volume = [(8/3 pi L . A1 . A2), where L is LA length, A1 and A2 are LA area in 4-chambers and 2-chambers, respectively] including maximum (V max), minimum (V min), and pre-atrial contraction (V pre-A), total atrial stroke volume (TA-SV), TA emptying fraction (TA-EF), active atrial SV (AA-SV), AA-EF, passive atrial SV (PA-SV), PA-EF, atrial expansion index (AEI), and LA kinetic energy (LA-KE) = (1/2) x AA-SV x P x V2. RESULTS: LAD, LA mass, V max, V min, and V pre-A were significantly higher in HCM than controls. TA-SV and TA-EF were comparable in both HCM subgroups and controls. AA-SV and LA-KE were significantly higher in both HCM subgroups than controls. LA-KE was significantly higher in obstructive HCM than non-obstructive (P < 0.001). PA-EF and AEI were significantly lower in obstructive HCM than controls (P < 0.05). CONCLUSION: HCM is associated with increased LA size and augmented LA pump function especially obstructive type. LA conduit and reservoir functions are impaired in obstructive HCM.
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Anwar et al. (2007) conducted a case-control in Hypertrophic cardiomyopathy (n=50). Two-dimensional echocardiography vs. Normal age-matched controls was evaluated on Left atrial mass (p=<0.0001). Hypertrophic cardiomyopathy patients had significantly higher left atrial mass (89.8 g vs 32.3 g) and augmented left atrial pump function compared to normal controls.
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