Identifying Adverse Remodeling in Hypertrophic Cardiomyopathy Phenotypes Role of Left Atrial Parameters

Dutt Shivam; Tandon Rohit; Sondh Mandeep Singh; Bansal Namita; Singh Gurbhej; Mohan Bishav; Singh Bhupinder; Wander Gurpreet Singh

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자료유형: 학술저널

저자정보: Dutt Shivam (Hero DMC Heart Institute Ludhiana Punjab India.) Tandon Rohit (Hero DMC Heart Institute Ludhiana Punjab India.) Sondh Mandeep Singh (Hero DMC Heart Institute Ludhiana Punjab India.) Bansal Namita (Hero DMC Heart Institute Ludhiana Punjab India.) Singh Gurbhej (Hero DMC Heart Institute Ludhiana Punjab India.) Mohan Bishav (Hero DMC Heart Institute Ludhiana Punjab India.) Singh Bhupinder (Hero DMC Heart Institute Ludhiana Punjab India.) Wander Gurpreet Singh (Hero DMC Heart Institute Ludhiana Punjab India.)

저널정보: 아시아심장혈관영상의학회 Cardiovascular Imaging Asia Cardiovascular Imaging Asia Vol.5 No.1

발행연도: 2021.1

수록면: 2 - 8 (7page)

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Objective: Documenting adverse remodeling in absence of left ventricular outflow tract (LVOT) obstruction and mitral regurgitation in a classical hypertrophic cardiomyopathy (HCMP) phenotype is difficult. Changes in the left atrium (LA) are a consequence of progressive left ventricular (LV) fibrosis and have been shown to progress in a linear fashion. Therefore, studying LA changes for identifying adverse remodeling in HCMP patients is important. Materials and Methods: This was a prospective study which included HCMP patients and age- and gender-matched controls. Various echocardiographic parameters of adverse cardiac remodeling were investigated. Results: A total of 160 patients with HCMP and 75 age- and sex-matched controls were analyzed over a 5-year period. HCMP patients had an enlarged LA, greater segmental thickness, and mildly increased LV filling pressure. Patients with maximum LA volume >40 mL and global LA strain <21.5% showed greater maximum segmental thickness and increased ratio of pulse wave Doppler derived mitral E wave and tissue Doppler derived annular e wave with reduced LA strain and LV strain, LA emptying fraction, and strain-derived LV ejection fraction. In both groups, significant difference was not observed in age, sex, HCMP phenotype, presence or absence of LVOT obstruction, LV volume, and mitral Doppler ratio of pulse wave Doppler derived mitral E and A waves. Conclusion: Monitoring HCMP in asymptomatic patients is challenging. Assessment of adverse cardiac remodeling in classical HCMP phenotype is feasible using global LA strain and maximum LA volume. Global LA strain identifies early changes and maximum LA volume late changes of cardiac remodeling and therefore provide an early indication of disease progression in asymptomatic HCMP patients.

#Hypertrophic cardiomyopathy #Left atrial strain #Adverse remodeling

참고문헌 (14)

참고문헌 신청

Roberts R / 2001 / New concepts in hypertrophic cardiomyopathies, part I / Circulation 104:2113~2116

Maron BJ / 2002 / Hypertrophic cardiomyopathy: a systematic review / JAMA 287:1308~1320

Paraskevaidis IA / 2009 / Evaluation of left atrial longitudinal function in patients with hypertrophic cardiomyopathy: a tissue Doppler imaging and twodimensional strain study / Heart 95:483~489

Brown J / 2009 / Use of myocardial strain to assess global left ventricular function: a comparison with cardiac magnetic resonance and 3-dimensional echocardiography / Am Heart J 157:102.e1~102.e5

Lang RM / 2015 / Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging / J Am Soc Echocardiogr 28:1~39

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