title: Assessment of left atrial ejection force in hypertrophic cardiomyopathy using real-time three-dimensional echocardiography.
abstract: The study included 30 patients with hypertrophic cardiomyopathy (HCM) (obstructive and nonobstructive) and 15 control subjects. End-diastolic mitral annulus area (MAA(3D)) and mitral valve area (MVA(3D)) were measured by real-time 3-dimensional (3D) echocardiography. MVA(2D) and peak mitral inflow A wave velocity (V) were measured by 2-dimensional (2D) echocardiography. Left atrial ejection force (LA-EF) was calculated by 2D echocardiography and real-time 3D echocardiography using the formula: 0.5 x 1.06 x (MAA or MVA) x V2, where (1.06) is blood viscosity. LA-EF(2D-MVA), LA-EF(3D-MVA), LA-EF(3D-MAA), and V were significantly higher in patients with HCM than control subjects (P < .001). LA-EF(2D-MVA) and LA-EF(3D-MVA) were lower than LA-EF(3D-MAA) in HCM only (P < .001). In obstructive HCM, LA-EF(2D-MVA), LA-EF(3D-MVA), LA-EF(3D-MAA), and V were significantly higher than in nonobstructive HCM (P < .05). Left ventricular outflow tract gradient contributed independently to high LA-EF in obstructive HCM. We concluded that HCM is associated with higher LA-EF than normal, and higher in obstructive HCM than nonobstructive indicating a higher atrial workload that is reflected by LA-EF(3D-MAA).
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Ashraf M
authors.initials: AM
authors.lastname: Anwar
authors.forename: Osama I I
authors.initials: OI
authors.lastname: Soliman
authors.forename: Marcel L
authors.initials: ML
authors.lastname: Geleijnse
authors.forename: Michelle
authors.initials: M
authors.lastname: Michels
authors.forename: Wim B
authors.initials: WB
authors.lastname: Vletter
authors.forename: Attila
authors.initials: A
authors.lastname: Nemes
authors.forename: Folkert J
authors.initials: FJ
authors.lastname: ten Cate
mesh_terms: D000328:Adult; D016279:Atrial Function, Left; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000209:etiology