Department of Radiology, Maslak Acibadem Hospital, Darussafaka Buyukdere St., No. 40, 34457, Sarıyer, Istanbul, Turkey.
Department of Radiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Pediatr Radiol. 2021 Apr;51(4):594-604. doi: 10.1007/s00247-020-04884-x. Epub 2021 Jan 20.
The maximum left atrial volume index is the most widely used metric for assessing the left atrium in hypertrophic cardiomyopathy; however, it may be normal in the early phases of the disease.
To assess whether pediatric hypertrophic cardiomyopathy patients with normal maximum left atrial volume index have impaired atrial functions on cardiac magnetic resonance imaging (MRI).
A total of 26 pediatric hypertrophic cardiomyopathy patients and 24 age-matched children, as controls, were enrolled in the study. The left atrial reservoir, conduit and booster strain were calculated from two orthogonal planes and the left atrial volumes were calculated using the biplanar method. The extent of left ventricular late gadolinium enhancement (LGE-%) was calculated using the thresholding method. The left ventricular early diastolic longitudinal strain rate was calculated to assess diastolic dysfunction.
The maximum left atrial volume index of the children with hypertrophic cardiomyopathy and the controls were not significantly different (P>0.05). Most of the left atrial functional indices were worse in children with hypertrophic cardiomyopathy (P<0.05), yet no difference was observed between the left atrial booster strains of the two groups (P>0.05). The left atrial conduit strain showed moderate to good negative correlations with left ventricular LGE-% and diastolic dysfunction.
Left atrial conduit and reservoir strains are impaired in pediatric hypertrophic cardiomyopathy patients with normal maximum left atrial volumetric indices. Most left atrial strain parameters are closely linked to left ventricular LGE-% and diastolic dysfunction. Left atrial strain analysis may reveal subtle functional changes in the atrium before the increase in the maximum volume index.
最大左心房容积指数是评估肥厚型心肌病左心房最常用的指标；然而，在疾病的早期阶段，它可能是正常的。
评估最大左心房容积指数正常的儿科肥厚型心肌病患者在心脏磁共振成像（MRI）上是否存在心房功能障碍。
共纳入 26 例儿科肥厚型心肌病患者和 24 例年龄匹配的儿童作为对照组。从两个正交平面计算左心房储备、传导和增强应变，并使用双平面法计算左心房容积。使用阈值法计算左心室晚期钆增强（LGE-%）的程度。计算左心室早期舒张纵向应变率以评估舒张功能障碍。
肥厚型心肌病患儿和对照组的最大左心房容积指数无显著差异（P>0.05）。肥厚型心肌病患儿的大多数左心房功能指标较差（P<0.05），但两组左心房增强应变无差异（P>0.05）。左心房传导应变与左心室 LGE-%和舒张功能障碍呈中等到良好的负相关。
最大左心房容积指数正常的儿科肥厚型心肌病患者存在左心房传导和储备应变受损。大多数左心房应变参数与左心室 LGE-%和舒张功能障碍密切相关。左心房应变分析可能在最大容积指数增加之前揭示心房的细微功能变化。
