The predictive value of left ventricular and left atrial mechanics for atrial fibrillation and heart failure in hypertrophic cardiomyopathy: a prospective cohort study

Zegkos, Thomas; Ntelios, Dimitrios; Parcharidou, Despοina; Katranas, Sotiris; Panagiotidis, Theofilos; Papanastasiou, Christos A.; Karagiannidis, Efstratios; Rouskas, Pavlos; Vassilikos, Vassilis; Karvounis, Haralampos; Efthimiadis, Georgios K.

doi:10.1007/s10554-021-02232-0

Cited by 10 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, the degree of myocardial fibrosis may be associated with both the impairment of LV systolic and diastolic properties 27 . On this basis, the GLS, which is an indirect expression of myocardial fibrosis, is associated with the diastolic dysfunction parameters including LA strain 27,28 . Significant MR, which is an established phenotypic expression of HCM, is recognized by this study as a factor independently associated with LA myopathy (Figure 2).…”

Section: Discussionmentioning

confidence: 70%

“…27 On this basis, the GLS, which is an indirect expression of myocardial fibrosis, is associated with the diastolic dysfunction parameters including LA strain. 27,28 Significant MR, which is an established phenotypic expression of HCM, is recognized by this study as a factor independently associated with LA myopathy (Figure 2). 3 LV GLS and LAVi as shown in Table 3 and warrants further investigation to elucidate the exact contribution of MR in LA myopathy in HCM patients.…”

Section: Discussionmentioning

confidence: 75%

“…LA reservoir strain has been recently reported to confer increased risk for sudden arrhythmic events beyond the established algorithms for risk prediction 33 . Moreover, it has been associated with increased incidence of atrial fibrillation and heart failure outcomes independently of LA volume 28 . Considering the above findings and taking into account the association between LA myopathy and significant MR shown in this study, the presence of more than mild MR, irrespective of its mechanism, may itself represent a marker signifying increased morbidity and mortality in HCM patients.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Mitral regurgitation impact on left atrial myopathy in hypertrophic cardiomyopathy

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background: : Recent studies have shown that mitral regurgitation (MR) represents a major determinant of left atrial (LA) function in patients with heart failure with preserved ejection fraction. The role of MR in determining LA myopathy in hypertrophic cardiomyopathy (HCM) is unknown. The aim of this study was to examine the association of MR with LA myopathy, assessed by LA strain values in HCM patients. Methods: : In total 250 consecutive patients (mean age 51 ± 16 years, 67.2% male) with an established diagnosis of HCM and with sinus rhythm at index echocardiography evaluation were included. LA reservoir, conduit and booster strain were analyzed, besides LA size, left ventricular (LV) systolic and diastolic function. The predictors of LA strain values were identified with linear regression analysis.Results: : Significant (more than mild) MR was a significant univariate predictor of all the three LA strain values. In multivariate linear regression analysis, independent predictors of LA reservoir strain were more than mild MR (r = −.23), LV global longitudinal strain (r = −.49), LA volume index (r = −.27) and patient age (r = −.23). Significant MR was also an independent determinant of LA conduit (r = −.17) and booster strain (r = −.12). In patients with LA volume index < 34 ml/m 2 more than mild MR was an independent predictor of LA reservoir (r = −.32) and conduit strain (r = −.27), but not LA booster strain.Conclusion: : Significant MR is associated with LA myopathy independently of the LV diastolic and systolic function and LA size.

show abstract

Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mitral regurgitation impact on left atrial myopathy in hypertrophic cardiomyopathy

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…After carefully reading the full text, a total of 13 studies reporting 2441 HCM patients were included in this meta‐analysis, 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 the flow diagram is shown in Figure 1 . The following features of eligible studies and risk of bias assessment using the NOS are summarized in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Prognostic value of global longitudinal strain in hypertrophic cardiomyopathy: A systematic review and meta‐analysis

Yang

Wang

et al. 2022

Clinical Cardiology

View full text Add to dashboard Cite

Background As previously reported, impairment of left ventricular global longitudinal strain (LVGLS) is associated with myocardial fibrosis, arrhythmias, and heart failure in hypertrophic cardiomyopathy (HCM) patients. Hypothesis This study aimed to estimate the association between LVGLS measured by echocardiography and major adverse cardiovascular events (MACE) in patients with HCM. Methods Pubmed, Embase, Scopus, and Cochrane Library databases were systematically searched for evaluating the difference of LVGLS between MACE and non‐MACE and the relevance of LVGLS and MACE in HCM patients, mean difference (MD), and pooled hazard ratios (HR) with 95% confidence interval (CI) were calculated. Publication bias was detected by funnel plots and Egger's test, and trim‐and‐fill analysis was employed when publication bias existed. Results A total of 13 studies reporting 2441 HCM patients were included in this meta‐analysis. Absolute value of LVGLS was lower in the group of HCM with MACE (MD = 2.74, 95% CI: 2.50–2.99, p < .001; I2 = 0, p = .48). In the pooled unadjusted model, LVGLS was related to MACE (HR = 1.14, 95% CI: 1.06–1.22, p < .05, I2 = 58.4%, p < .01) and there is a mild heterogeneity, and sensitivity analysis showed stable results. In the pooled adjusted model, LVGLS was related to MACE (HR = 1.12, 95% CI: 1.08–1.16, p < .05; I2 = 0%, p = .442). Egger's tests showed publication bias, and trim‐and‐fill analysis was applied, with final results similar to the previous and still statistically significant. Conclusion The meta‐analysis suggested that impaired LVGLS was associated with poor prognosis in HCM patients.

show abstract

“…Although all LA strain values can predict AF, the parameter with the best prognostic value is still under debate. Among 250 patients with hypertrophic cardiomyopathy that were followed up for a mean period of 2.5±1.2 years, LA reservoir strain had the highest predictive value 21 . Moreover, the predictive value of LA reservoir strain is greater in the secondary prevention of ischemic stroke 22 .…”

Section: Introductionmentioning

confidence: 99%

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

et al. 2021

View full text Add to dashboard Cite

Cardiovascular disease and chronic kidney disease are frequently inter‐connected and this association leads to an exponential growth of cardiovascular risk. This risk is currently underestimated by the existing algorithms and there is a constant need for new markers to predict adverse outcomes in this special population. In general population left atrial strain has emerged as an important tool for both the diagnosis and prognostic stratification, but data regarding its role in chronic kidney disease patients is scarce. The purpose of this review is to summarize the current evidence regarding this matter. Left atrial size and function mirror the duration and severity of increased left ventricular filling pressures. Increased left atrial volume index and impaired left atrial strain parameters are independent predictors for adverse cardiovascular events. Left atrial strain is impaired before changes in volume appear, thus being able to predict both diastolic and systolic function in chronic kidney disease patients. Finally, left atrial strain can identify renal patients with impaired exercise capacity and this could have clinical applications in the rehabilitation of this patients.

show abstract

The predictive value of left ventricular and left atrial mechanics for atrial fibrillation and heart failure in hypertrophic cardiomyopathy: a prospective cohort study

Cited by 10 publications

References 32 publications

Mitral regurgitation impact on left atrial myopathy in hypertrophic cardiomyopathy

Mitral regurgitation impact on left atrial myopathy in hypertrophic cardiomyopathy

Prognostic value of global longitudinal strain in hypertrophic cardiomyopathy: A systematic review and meta‐analysis

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

Contact Info

Product

Resources

About