Three-Dimensional Speckle Tracking Echocardiography Allows Detailed Evaluation of Left Atrial Function in Hypertrophic Cardiomyopathy-Insights from the MAGYAR-Path Study

IntroductionHypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. Reduced left atrial (LA) function was demonstrated in HCM by different methods. Three-dimensional (3D) speckle tracking echocardiography (STE) has just been introduced for the evaluation of LA. This study was designed to compare 3DSTE-derived LA volumetric and strain parameters in HCM with healthy controls. MethodsThe study comprised 23 consecutive HCM patients (mean age: 48.515.1years, 14 men). Their results were compared to 23 age- and gender-matched healthy controls. Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all cases. ResultsCalculated LA maximum (66.4 +/- 20.4mL vs. 36.0 +/- 6.1mL, P<0.0001) and minimum (39.2 +/- 19.1 vs. 16.0 +/- 4.6mL, P<0.0001) volumes and LA volume before atrial contraction (53.6 +/- 19.9 vs. 24.0 +/- 6.2mL, P<0.0001) were significantly increased in HCM patients. Atrial stroke volumes respecting cardiac cycles proved to be increased, while emptying fractions were decreased in subjects with HCM. Mean global radial (-12.2 +/- 6.7% vs. -19.6 +/- 11.7, P<0.05), longitudinal (26.5 +/- 16.5% vs. 29.8 +/- 12.1%, P<0.05) and 3D strain (-6.1 +/- 4.4% vs. -12.5 +/- 10.2%, P<0.05) proved to be significantly reduced in HCM patients as compared with matched controls. ConclusionsThree-dimensional speckle tracking echocardiography allows detailed evaluation of LA (dys) function in HCM by volumetric and strain measurements.