The relationship of left atrial volume and left atrial pressure in patients with hypertrophic cardiomyopathy: an echocardiographic and cardiac catheterization study.
BACKGROUND
Left atrial enlargement is a marker of diastolic dysfunction, which is present in most patients with hypertrophic cardiomyopathy (HCM). It is unclear as to whether left atrial volume is a reliable measure of ventricular filling pressures in these patients.


METHODS
Left atrial volume index (LAVI) was measured in 100 symptomatic patients with HCM using transthoracic echocardiography, followed by cardiac catheterization with transseptal measurement of left atrial pressure (LAP) and end-diastolic pressure within 48 hours.


RESULTS
LAVI was only modestly related to mean LAP (r=0.24, P=.02), and there was no significant relation to end-diastolic pressure (r=0.11, P=.28). The specificity of increased LAVI (>28 cm3/m2) for elevated LAP (>15 mm Hg) was poor (16%). However, all patients with normal LAVI had normal LAP.


CONCLUSIONS
Although left atrial size may reflect chronic changes due to diastolic dysfunction in HCM, the relation of increased LAVI to ventricular filling pressures is modest. Nonetheless, a normal LAVI suggests normal ventricular filling pressures in patients with HCM.
Geske
Jeffrey B
JB
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Sorajja
Paul
P
Nishimura
Rick A
RA
Ommen
Steve R
SR
D001794:Blood Pressure; D006328:Cardiac Catheterization / Q000379:methods*; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size