No abstract

Mitral annular disjunction was detected not only in patients with a myxomatous mitral valve but also in normal cases. The number of MVPs was significantly larger in patients with mitral annular disjunction than patients without mitral annular disjunction. Further investigation is needed to clarify the clinical significance of the mitral annular disjunction detected by routine echocardiography.

eft atrial (LA) enlargement is associated with cardiovascular disease and is a risk factor for atrial fibrillation, stroke, and death. 1,2 However, LA antero-posterior dimensions have well-known limitations for indicators of chamber size, for example, the left ventricular (LV) dimension is a poor indicator of LV volume. Two-dimensional (D) echocardiography-derived LA volume has been shown to provide a more accurate assessment of LA size than the M-mode LA dimension. [3][4][5][6][7][8] Recent studies demonstrated that the LA volume was more strongly associated with the future development of atrial fibrillation than LA dimension. 9,10 The LA volume was also strongly associated with the prognosis of patients with acute myocardial infarction 11 and dilated cardiomyopathy. 12 Methods to calculate LA volume have been described, [3][4][5][6] but the distribution of LA volume in normal Japanese subjects who do not have cardiovascular disease has not been reported. Our objective was to provide reference ranges of the LA volume in healthy Japanese adults. Methods Study SubjectsEligible subjects were adults ≥20 years of age who were referred for outpatient transthoracic echocardiographic examination because of non-specific chest symptoms. All subjects had sinus rhythm, and no history of atrial arrhyth-

AimsTo prospectively evaluate the relationship between left atrial volume (LAV) and the risk of clinical events in patients with hypertrophic cardiomyopathy (HCM).MethodsWe enrolled a total of 141 HCM patients with sinus rhythm and normal pump function, and 102 patients (73 men; mean age, 61 ± 13 years) who met inclusion criteria were followed for 30.8 ± 10.0 months. The patients were divided into two groups with or without major adverse cardiac and cerebrovascular events (MACCE), a composite of stroke, sudden death, and congestive heart failure. Detailed clinical and echocardiographic data were obtained.ResultsMACCE occurred in 24 patients (18 strokes, 4 congestive heart failure and 2 sudden deaths). Maximum LAV, minimum LAV, and LAV index (LAVI) corrected for body surface area (BSA) were significantly greater in patients with MACCE than those without MACCE (maximum LAV: 64.3 ± 25.0 vs. 51.9 ± 16.0 ml, p = 0.005; minimum LAV: 33.9 ± 15.1 vs. 26.2 ± 10.9 ml, p = 0.008; LAVI: 40.1 ± 15.4 vs. 31.5 ± 8.7 ml/mm2, p = 0.0009), while there were no differences in the other echocardiographic parameters.LAV/BSA of ≥ 40.4 ml/m2 to identify patients with cardiovascular complications with a sensitivity of 73% and a specificity of 88%.ConclusionLAVI may be an effective marker for detecting the risk of MACCE in patients with HCM and normal pump function.

SDI derived from 3DE is a useful parameter to assess global LV systolic dyssynchrony and predict responses to CRT.