Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
J Am Soc Echocardiogr. 2010 Oct;23(10):1090-8. doi: 10.1016/j.echo.2010.07.016. Epub 2010 Aug 23.
Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. We aimed to assess left atrial (LA) function by two-dimensional speckle tracking echocardiography and its relation with left ventricular (LV) function and clinical status in patients with HCM.
We prospectively enrolled 37 consecutive patients with HCM and 37 normal subjects with similar age and gender distribution. Longitudinal LV strain (ε) and LA ε and strain rate (Sr) parameters (systolic, early diastolic, and late diastolic during atrial contraction) were assessed.
Peak LAε and LA Sr parameters were significantly lower in patients compared with controls (P ≤ .001 for all). In patients, all LA function parameters correlated with LVε (P < .003 for all). Indexed LA volume, LA function parameters, and mitral regurgitation degree were the main correlates of New York Heart Association class; late diastolic strain rate during atrial contraction was the only independent predictor of symptomatic status.
In patients with HCM, LA function is significantly reduced and related to LV dysfunction. Moreover, LA booster pump function emerged as an independent correlate of heart failure symptoms in this setting.
肥厚型心肌病（HCM）是一种影响心室和心房心肌的全身性肌病过程。我们旨在通过二维斑点追踪超声心动图评估 HCM 患者的左心房（LA）功能，并评估其与左心室（LV）功能和临床状况的关系。
我们前瞻性纳入 37 例连续 HCM 患者和 37 例年龄和性别分布相似的正常对照者。评估纵向 LV 应变（ε）和 LAε和应变率（Sr）参数（收缩期、早期舒张期和心房收缩期晚期舒张期）。
与对照组相比，患者的峰值 LAε和 LA Sr 参数明显降低（所有 P ≤.001）。在患者中，所有 LA 功能参数均与 LVε相关（所有 P <.003）。LA 容积指数、LA 功能参数和二尖瓣反流程度是纽约心脏协会（NYHA）心功能分级的主要相关因素；心房收缩晚期应变率是有症状状态的唯一独立预测因素。
在 HCM 患者中，LA 功能明显降低，与 LV 功能障碍相关。此外，LA 助推泵功能是该人群心力衰竭症状的独立相关因素。
