Left Atrial Volumetric and Strain Analysis by Three-Dimensional Speckle-Tracking Echocardiography in Noncompaction Cardiomyopathy: Results from the MAGYAR-Path Study

Introduction: Noncompaction cardiomyopathy (NCCM) is a rare congenital cardiomyopathy characterised by a distinctive 2-layered appearance of the myocardium due to hypertrabecularisation and deep intertrabecular recesses. The present study was designed to assess left atrial (LA) volumes and volumetric and strain-based functional properties by three-dimensional speckle-tracking echocardiography (3DSTE) in NCCM. Methods: The study included 12 consecutive NCCM patients. Their results were compared to 20 age-and sex-matched healthy controls. Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all cases. Results: Calculated LA maximum (76.5 +/- 26.8 mL vs. 45.3 +/- 15.1 mL, p=0.0002) and minimum (56.9 +/- 27.3 mL vs. 25.3 +/- 15.2 mL, p=0.0002) volumes and LA volume before atrial contraction (67.1 +/- 28.2 mL vs. 35.7 +/- 16.4 mL, p=0.0004) were significantly greater in NCCM patients. Total, active, and passive LA emptying fractions proved to be smaller in NCCM. Peak global radial (-9.3 +/- 7.8% vs. -16.8 +/- 10.2%, p=0.05), circumferential (12.8 +/- 8.4% vs. 26.2 +/- 9.2%, p=0.0003), longitudinal (12.8 +/- 8.2% vs. 22.5 +/- 8.5%, p=0.004), and area (26.7 +/- 18.5% vs. 51.6 +/- 20.3%, p=0.001) strains were significantly smaller in NCCM patients as compared to matched controls. Conclusions: Significantly greater LA volumes and compromised LA functional properties could be demonstrated by 3DSTE in patients with NCCM.