Characterization of Left Atrial Mechanics in Hypertrophic Cardiomyopathy and Essential Hypertension Using Vector Velocity Imaging

Abstract

Response of LA mechanics to pathologic hypertrophy is entirely different. In HCM LA reservoir and conduit functions are more deteriorated and related to the severity of phenotype, while in hypertension the conduit function is chiefly affected and LA dysfunction is linked to a more advanced disease.

Hypertensive patients with left ventricular hypertrophy have global left atrial dysfunction and impaired atrio-ventricular coupling

“…However, in clinical practice, we do not routinely assess the different components of LA function, although this is now possible because of advances in noninvasive imaging techniques. Recent studies based on tissue Doppler imaging [9], vector velocity imaging (VVI) [10,11], or speckle tracking imaging (STE) [12][13][14][15][16] assessed LA function in patients with HTN with or without LV hypertrophy. However, literature data concerning LA strains in patients with HTN are conflicting.…”

“…However, literature data concerning LA strains in patients with HTN are conflicting. Left atrial reservoir function has been shown to be reduced [12,13] or normal in patients with LV hypertrophy [10,11], whereas it showed early impairment in some studies of HTN patients without hypertrophy [14][15][16]. LA conduit function has been more consistently shown to be reduced, regardless of LV mass [9][10][11]13,15,16].…”

“…Left atrial reservoir function has been shown to be reduced [12,13] or normal in patients with LV hypertrophy [10,11], whereas it showed early impairment in some studies of HTN patients without hypertrophy [14][15][16]. LA conduit function has been more consistently shown to be reduced, regardless of LV mass [9][10][11]13,15,16]. Finally, LA booster pump function has been reported as normal [9,10], increased [11,12,14] or reduced [13].…”

“…LA conduit function has been more consistently shown to be reduced, regardless of LV mass [9][10][11]13,15,16]. Finally, LA booster pump function has been reported as normal [9,10], increased [11,12,14] or reduced [13]. As opposed to tissue Doppler imaging, STE offers the advantage to be angle independent and unaffected by adjacent structures and tethering of neighbouring segments.…”

Focus on atrial function: benefits of three-dimensional speckle-tracking echocardiography

“…Badran et al found that in hypertension LA conduit function is chiefly affected and LA dysfunction is linked to a more advanced disease (45).…”