Kobayashi Yukari, Wheeler Matthew, Finocchiaro Gherardo, Ariyama Miyuki, Kobayashi Yuhei, Perez Marco V, Liang David, Kuznetsova Tatiana, Schnittger Ingela, Ashley Euan, Haddad Francois
Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA.
Stanford Cardiovascular Institute, Stanford, CA, USA.
Echocardiography. 2017 Jun;34(6):843-850. doi: 10.1111/echo.13533. Epub 2017 Apr 1.
Few studies have analyzed changes in left atrial (LA) function associated with different phenotypes of asymmetric hypertrophic cardiomyopathy (HCM). We sought to demonstrate the association of impairments in LA function with disease phenotype in patients with obstructive and nonobstructive HCM.
From Stanford Cardiomyopathy Registry, we randomly selected 50 age-/sex-matched healthy controls, 35 patients with nonobstructive HCM (HCM 1), 35 patients with obstructive HCM (HCM 2), and 35 patients with obstructive HCM requiring septal reduction therapy (HCM 3). Echocardiography was performed to evaluate left ventricular (LV) strain as well as LA function including LA emptying fraction and LA strain.
The mean age was 51±14 years and 57% were male. LA volume index differed among all four predefined groups (25.6±6.7 mL/m in controls, 32.2±13.3 mL/m in HCM 1, 42.0±12.9 mL/m in HCM 2, 52.4±15.2 mL/m for HCM 3, and P<.05 all between groups). All measurement of LA function was impaired in patients with HCM than controls. Total and passive LA function was further impaired in HCM 2 or 3 compared with HCM 1, while active LA function was not different among the three groups. Among LV strains, only septal longitudinal strain differed among all groups (-18.5±1.9% in controls, -14.5±1.9% in HCM 1, -13.3±1.8% in HCM 2, -11.6±2.3% in HCM 3, and P<.05 all between groups).
LA function was impaired in patients with HCM even in minimally symptomatic nonobstructive phenotype. Total and passive LA function was further impaired in patients with obstructive HCM.
很少有研究分析与不对称肥厚型心肌病（HCM）不同表型相关的左心房（LA）功能变化。我们试图证明梗阻性和非梗阻性HCM患者LA功能损害与疾病表型之间的关联。
从斯坦福心肌病登记处，我们随机选择了50名年龄/性别匹配的健康对照者、35名非梗阻性HCM患者（HCM 1）、35名梗阻性HCM患者（HCM 2）和35名需要间隔减容治疗的梗阻性HCM患者（HCM 3）。进行超声心动图检查以评估左心室（LV）应变以及LA功能，包括LA排空分数和LA应变。
平均年龄为51±14岁，男性占57%。在所有四个预定义组中，LA容积指数不同（对照组为25.6±6.7 mL/m，HCM 1为32.2±13.3 mL/m，HCM 2为42.0±12.9 mL/m，HCM 3为52.4±15.2 mL/m，组间P<0.05）。与对照组相比，HCM患者的所有LA功能测量均受损。与HCM 1相比，HCM 2或3的LA总功能和被动功能进一步受损，而三组之间的LA主动功能无差异。在LV应变中，只有间隔纵向应变在所有组中不同（对照组为-18.
