title: Two-dimensional strain analysis in patients with hypertrophic cardiomyopathy and normal systolic function: a 12-month follow-up study.
abstract: BACKGROUND
  Although left ventricular (LV) and left atrial (LA) echo indices may reliably reflect loading conditions in patients with hypertrophic cardiomyopathy (HCM), little is known about 2-dimensional strain imaging. We evaluated LV and LA 2-dimensional strain imaging in relation to long-term outcome in patients with HCM.
  
  
  METHODS
  Fifty consecutive patients (58% men, aged 51 +/- 18 years) with familial HCM and normal LV ejection fraction underwent 2-dimensional LV and LA strain imaging; total LA strain was defined as the sum of maximum positive and maximum negative atrial strain. Patients were followed up for 12 months for cardiovascular events, defined as death or hospitalization for cardiovascular causes.
  
  
  RESULTS
  Twenty patients (40%) experienced an event after a median time of 98 days: 2 (4%) died and 18 (36%) were hospitalized. In multivariate analysis, total LA strain was the strongest predictor of 12-month outcome (odds ratio 0.858, 95% CI 0.771-0.954, P = .005); a cutoff of 21% predicted events with 90% sensitivity and 86% specificity. Total LA strain was also an independent predictor of atrial fibrillation requiring hospitalization (odds ratio 0.853, 95% CI 0.748-0.972, P = .017).
  
  
  CONCLUSIONS
  In patients with HCM and normal systolic function, total LA strain predicts 12-month outcome in terms of death and/or hospitalization.
authors.affiliation: Second Department of Cardiology, Athens University Medical School, Attikon University Hospital, Athens, Greece. iparas@otenet.gr
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Paraskevaidis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Farmakis
authors.forename: Costantinos
authors.initials: C
authors.lastname: Papadopoulos
authors.forename: Ignatios
authors.initials: I
authors.lastname: Ikonomidis
authors.forename: John
authors.initials: J
authors.lastname: Parissis
authors.forename: Aggelos
authors.initials: A
authors.lastname: Rigopoulos
authors.forename: Efstathios K
authors.initials: EK
authors.lastname: Iliodromitis
authors.forename: Dimitrios Th
authors.initials: DT
authors.lastname: Kremastinos
mesh_terms: D000328:Adult; D000368:Aged; D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D013599:Systole