Key result
Hemophilia is associated with mild left atrial functional abnormalities, including a significantly reduced total atrial emptying fraction (41.1% vs 47.9%) compared to matched healthy controls.
Why the study?
Abnormalities in myocardial mechanics could be theorized in hemophilia due to hypocoagulability and related blood changes, but detailed left atrial properties were not assessed.
Does hemophilia affect left atrial volumetric and functional properties assessed by 3D speckle-tracking echocardiography compared to matched controls?
Case-Control (n=37)
No
Does hemophilia affect left atrial volumetric and functional properties assessed by 3D speckle-tracking echocardiography compared to matched controls?
Hemophilia is associated with mild left atrial functional abnormalities, specifically impaired reservoir function and strains, without volumetric changes.
Should not change hemophilia care; leaves open whether mild atrial changes predict events or merit prospective study.
Introduction: Hemophilia is an inherited disorder due to deficiencies in factor VIII (type A) and factor IX (type B). Abnormalities in myocardial mechanics could be theorized due to hemophilia-associated hypocoagubility and related quantitative and qualitative changes of the blood. The present study aimed a detailed assessment of left atrial (LA) volumetric and functional properties in patients with hemophilia using three-dimensional speckle-tracking echocardiography (3DSTE). Materials and Methods: The study consisted of 12 subjects with hemophilia type A and 2 cases with hemophilia type B (mean age: 40.8 ± 19.1 years, all males). Results of hemophilia patients were compared to that of 23 age-, gender- and risk factor-matched controls (42.4 ± 9.0 years, all males). Routine two-dimensional Doppler echocardiography and 3DSTE were performed in all subjects. Results: LA volumes respecting cardiac cycle did not differ between controls and hemophilia patients. From LA volume-based functional properties, LA stroke volumes were similar between the groups examined in all phases of LA function. While total atrial emptying fraction featuring LA reservoir function was reduced in patients with hemophilia compared to that of controls, passive and active atrial emptying fraction characterizing LA conduit and booster pump functions were similar between the groups. From LA strains, peak mean segmental circumferential and longitudinal LA strains were impaired in patients with hemophilia, other peak LA strains were similar between the groups. LA strains at atrial contraction did not differ between groups of hemophilia patients and controls. Conclusions: Hemophilia is not associated with LA volumetric changes, but mild LA functional abnormalities are present.
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Nemes et al. (2022) conducted a case-control in Hemophilia (n=37). Hemophilia vs. Healthy controls was evaluated on Total atrial emptying fraction (TAEF) (p=<0.05). Hemophilia is associated with mild left atrial functional abnormalities, including a significantly reduced total atrial emptying fraction (41.1% vs 47.9%) compared to matched healthy controls.
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