An integrated approach to determine left atrial volume, mass and function in hypertrophic cardiomyopathy by two-dimensional echocardiography.
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).


CONCLUSIONS
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.
Anwar
Ashraf M
AM
Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Room Ba 304, Dr Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
Soliman
Osama I I
OI
Nemes
Attila
A
Geleijnse
Marcel L
ML
ten Cate
Folkert J
FJ
D000328:Adult; D016279:Atrial Function, Left; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012107:Research Design; D012189:Retrospective Studies; D014463:Ultrasonography