Key result
The combination of left atrial peak strain ≤ 22% and left ventricular global longitudinal strain ≥ -16% strongly predicted a history of atrial fibrillation in patients with hypertrophic cardiomyopathy (OR 76.36).
Why the study?
AF is an important arrhythmia in HCM, but whether a complex LV evaluation using modern echocardiography techniques in addition to LA evaluation boosts the probability of AF diagnosis was unknown.
Does combined evaluation of left ventricular and left atrial strain using modern echocardiography predict a history of atrial fibrillation in patients with hypertrophic cardiomyopathy?
Cross-Sectional (n=83)
No
Does combined evaluation of left ventricular and left atrial strain using modern echocardiography predict a history of atrial fibrillation in patients with hypertrophic cardiomyopathy?
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Combined assessment of left ventricular global longitudinal strain and left atrial peak strain significantly enhances the identification of hypertrophic cardiomyopathy patients who have a history of atrial fibrillation.
Atrial fibrillation (AF) is an important arrhythmia in hypertrophic cardiomyopathy (HCM). We aimed to explore whether a complex evaluation of the left ventricle (LV) using modern echocardiography techniques, additionally to the left atrium (LA) boosts the probability of AF diagnosis. Standard echocardiography, 2D and 3D speckle tracking, were performed for LA and LV evaluation in HCM patients and healthy volunteers. Of 128 initially qualified HCM patients, 60 fulfilled included criteria, from which 43 had a history of AF, and 17 were without AF. LA volume index and peak strain, LV ejection fraction, and strains were significant predictors of AF. In addition, 2D global longitudinal strain (GLS) for LV at cut off −16% turned out to be the most accurate predictor of AF (OR 48.00 [95% CI 2.68–859.36], p = 0.001), whereas the combination of LA peak strain ≤ 22% and LV GLS ≥ −16% had the highest discriminatory power (OR 76.36 [95% CI 4.13–1411.36], p = 0.001). AF in HCM patients seems to be LA as well as LV disease. Revealing lower strain for LV, in addition to lower LA strain, may have an important impact on accurate characteristics of HCM patients with AF history.
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Wabich et al. (2021) conducted a cross-sectional in Hypertrophic cardiomyopathy (HCM) (n=83). Impaired 2D left ventricular global longitudinal strain (≥ -16%) and left atrial peak strain (≤ 22%) vs. Preserved left ventricular and left atrial strain was evaluated on History of atrial fibrillation (AF) (OR 76.36, 95% CI 4.13-1411.36, p=0.001). The combination of left atrial peak strain ≤ 22% and left ventricular global longitudinal strain ≥ -16% strongly predicted a history of atrial fibrillation in patients with hypertrophic cardiomyopathy (OR 76.36).
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