Characterization of left atrial dysfunction in hypereosinophilic syndrome – Insights from the Motion analysis of the heart and great vessels by three-dimensional speckle tracking echocardiography in pathological cases (MAGYAR-Path) Study

The present study was designed to compare three-dimensional speckle tracking echocardiography (3DSTE)-derived left atrial (LA) volumetric, volume-based functional and strain parameters between patients with hypereosinophilic syndrome (HES) and matched controls. A total of 10 HES patients and 19 age- and gender-matched healthy controls were included in the study. Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all HES cases and controls. Significantly increased maximum (72.9±38.8 ml vs. 45.6±15.5 ml, p=0.01) and minimum (46.3±33.3 ml vs. 26.0±15.0 ml, p=0.03) LA volumes and LA volume before atrial contraction (62.0±36.0 ml vs. 36.5±16.6 ml, p=0.01) were found in HES patients compared to controls. Both peak global (18.3±6.7% vs. 25.6±9.0%, p=0.03) and mean segmental (22.2±6.0% vs. 31.0±12.1%, p=0.04) circumferential strains were significantly reduced in HES patients, suggesting decreased LA reservoir function. Increased LA volumes can be demonstrated in HES patients, accompanied by reduced LA peak circumferential strain as assessed by 3DSTE, suggesting LA remodeling. O presente estudo foi concebido para comparar parâmetros volumétricos auriculares esquerdos derivados por ecocardiografia tridimensional speckle tracking, parâmetros funcionais e strain baseados no volume entre doentes com síndrome hipereosinofílica e controlos equiparados. Um total de dez doentes HES e de 19 controlos saudáveis, equiparados para idade e género, foram incluídos no estudo. O estudo completo ecocardiográfico bidimensional, Doppler e 3DSTE, foi realizado em todos os casos HES e controlos. Encontrou-se em doentes com HES, comparativamente com os controlos, um aumento significativo dos volumes auriculares esquerdos (72,9 ± 38,8 ml versus 45,6 ± 15,5 ml, p = 0,01), mínimo (46,3 ± 33,3 ml versus 26,0 ± 15,0 ml, p = 0,03) e volume auricular esquerdo antes da contração auricular (62,0 ± 36,0 ml versus 36,5 ± 16,6 ml, p = 0,01). Ambos strains circunferenciais pico, global (18,3 ± 6,7% versus 25,6 ± 9,0%, p = 0,03) e segmentar médio (22,2 ± 6,0% versus 31,0 ± 12,1%, p = 0,04) eram significativamente reduzidos em doentes HES, sugerindo diminuição de função auricular esquerda de reservatório. O aumento de volumes auriculares esquerdos foi demonstrado nos doentes HES, sendo acompanhado por redução de strain circunferencial pico da aurícula esquerda conforme avaliado por 3DSTE, sugerindo remodelagem auricular esquerda.