Key result
Late diastolic strain rate at the mid left atrium was significantly impaired in patients with left ventricular hypertrophy (-0.97 1/sec) and hypertrophic cardiomyopathy (-0.82 1/sec) compared to normal controls (-1.65 1/sec, p=0.002).
Why the study?
Left atrial function is difficult to evaluate due to ventricle-dependent dynamic movement, and its assessment using velocity vector imaging across patients with HCMP, hypertensive LVH, and controls required investigation.
Does left atrial velocity vector imaging (VVI) detect early diastolic dysfunction in patients with left ventricular hypertrophy and hypertrophic cardiomyopathy compared to normal controls?
Observational (n=39)
Blinded image analysis
No
Does left atrial velocity vector imaging (VVI) detect early diastolic dysfunction in patients with left ventricular hypertrophy and hypertrophic cardiomyopathy compared to normal controls?
Absolute Event Rate: -0.82% vs -1.65%
p-value: p=0.002
Impaired mid-LA late diastolic strain rate may mark early dysfunction in LVH/HCM; hypothesis-generating and requires larger validation before clinical adoption.
BACKGROUND: The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging (VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls. METHODS: Fourteen patients with HCMP (72% male, mean age of 52.6 ± 9.8), 15 hypertensive patients with LVH (88% male, mean age of 54.0 ± 15.3), and 10 age-matched controls (83% male, mean age of 50.0 ± 4.6) were prospectively studied. Echocardiographic images of the LA were analyzed with VVI, and strain rate (SR) was compared among the 3 groups. RESULTS: The e' velocity (7.7 ± 1.1; 5.1 ± 0.8; 4.5 ± 1.3 cm/sec, p = 0.013), E/e' (6.8 ± 1.6; 12.4 ± 3.3; 14.7 ± 4.2, p = 0.035), and late diastolic SR at mid LA (-1.65 ± 0.51; -0.97 ± 0.55; -0.82 ± 0.32, p = 0.002) were significantly different among the groups (normal; LVH; HCMP, respectively). The e' velocity, E/e', and late diastolic SR at mid LA were significantly different between normal and LVH (p = 0.001; 0.022; 0.018), whereas LA size was similar between normal and LVH (p = 0.592). The mean late diastolic peak SR of mid LA was significantly correlated with indices of diastolic function (E/e', e', and LA size). CONCLUSIONS: The SR is a useful tool for detailed evaluation of LA function, especially early dysfunction of LA in groups with normal LA size.
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Yoon et al. (2022) conducted an observational in Hypertrophic cardiomyopathy and left ventricular hypertrophy (n=39). Hypertrophic cardiomyopathy and left ventricular hypertrophy vs. Normal controls was evaluated on Late diastolic strain rate at mid left atrium (p=0.002). Late diastolic strain rate at the mid left atrium was significantly impaired in patients with left ventricular hypertrophy (-0.97 1/sec) and hypertrophic cardiomyopathy (-0.82 1/sec) compared to normal controls (-1.65 1/sec, p=0.002).
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