Atrial functions assessed by colour doppler myocardial imaging in hypertrophic cardiomyopathy

Abstract

Objective: Deterioration in atrial functions can lead to acute hemodynamic decompensation in patients with hypertrophic cardiomyopathy (HCM). The question of whether the atrial dysfunction may be explained primarily by the hemodynamic impact of left ventricle on atria or an underlying cardiomyopathic process remains unresolved. We aimed to investigate atrial functions in patients with HCM by using atrial myocardial color doppler imaging. Material and Methods: Left atrial (LA) and right atrial (RA) functional parameters in 15 patients with HCM and 15 age matched healthy controls were compared echocardiographically. Left atrial volumes and LA ejection fraction (LA ejection volume/Vmax X 100) were calculated. Atrial myocardial systolic, early and late diastolic velocities, peak systolic strain (SI) and strain rate (SR) were all measured by color doppler myocardial imaging. Results: Left atrial diameter was higher and LA ejection fraction was lower in the HCM group compared with those of the control group (p<0.05). Peak systolic and diastolic atrial myocardial velocities were compromised in HCM patients compared to healthy subjects. The peak systolic atrial myocardial strain and strain rate values in each studied atrial wall was lower in the HCM group but the difference reached statistically significance only for the RA wall. (RA SI; 62.6±42.2% vs. 97.9±45.1%, p=0.047, RA SRI; 2.3 ±1.7 vs. 3.7±1.2, p=0.031). Conclusion: Atrial myocardial deformation properties were impaired in patients with HCM. These results support the idea of increase in atrial stiffness in HCM and the hypothesis that HCM is a cardiac myopathic disease that involves the entire heart muscle. Copyright © 2012 by Türkiye Klinikleri.