PMID- 27741021
OWN - NLM
STAT- MEDLINE
DCOM- 20171109
LR  - 20181202
IS  - 1536-0210 (Electronic)
IS  - 0020-9996 (Linking)
VI  - 52
IP  - 3
DP  - 2017 Mar
TI  - Left Atrial Performance in the Course of Hypertrophic Cardiomyopathy: Relation to 
      Left Ventricular Hypertrophy and Fibrosis.
PG  - 177-185
LID - 10.1097/RLI.0000000000000326 [doi]
AB  - OBJECTIVES: Hypertrophic cardiomyopathy (HCM) is associated with left atrial (LA) 
      functional abnormalities. The determinants and the degree of LA dysfunction in 
      the course of HCM are not fully understood. We aimed to characterize LA mechanics 
      in HCM, according to the extent of left ventricular (LV) hypertrophy and 
      fibrosis. METHODS AND RESULTS: Seventy-three HCM patients and 23 age- and 
      sex-matched controls underwent cardiovascular magnetic resonance imaging 
      including late gadolinium enhancement (LGE). LA reservoir, conduit, and 
      contractile functions were quantified by fractional volume changes and 
      cardiovascular magnetic resonance feature-tracking-derived strain and strain 
      rate. In multivariable regression, LA mechanics were associated with the extent 
      of LV LGE (P = 0.033 to P < 0.001), but not with the LV mass extent or maximum 
      wall thickness (P = 0.108 to P = 0.964). Left atrial function decreased according 
      to the increase in extent of LV fibrosis (non-LGE; mild LGE </= 10%; intermediate 
      LGE 11%-19%; severe LGE >/= 20%). Compared with healthy controls, LA conduit 
      function was impaired in HCM with no LGE already (LA emptying fraction conduit: 
      32% +/- 7% vs 26 +/- 14, P = 0.037). Conversely, LA contractile booster pump function 
      was impaired in HCM with severe LGE only (LA emptying fraction booster: 40% +/- 8% 
      vs 20% +/- 10%, P < 0.001; for controls vs LGE >/= 20%, respectively). CONCLUSIONS: 
      Left atrial functional abnormalities are associated with LV fibrosis, but not 
      with LV hypertrophy. While LA conduit function is impaired in early HCM stages as 
      represented by mild or absent LV fibrosis, LA contractile function is impaired 
      later in the course of disease progression as demonstrated by the presence of 
      severe LV fibrosis only. These novel markers of LA performance may potentially 
      proof useful for disease staging and early detection of cardiac deterioration.
FAU - Kowallick, Johannes T
AU  - Kowallick JT
AD  - From the *Division of Imaging Sciences and Biomedical Engineering, Department of 
      Cardiovascular Imaging, King's College London, St Thomas' Hospital, London, 
      United Kingdom; daggerInstitute for Diagnostic and Interventional Radiology, 
      University Medical Centre Gottingen, Georg-August-University; double daggerDZHK (German 
      Centre for Cardiovascular Research), Partner Site Gottingen, Gottingen, Germany; 
       section signChildren's Hospital and Medical Center, University of Nebraska College of 
      Medicine, Omaha, NE; and  parallelDepartment of Cardiology and Pneumology, University 
      Medical Centre Gottingen, Georg-August-University, Gottingen, Germany.
FAU - Silva Vieira, Miguel
AU  - Silva Vieira M
FAU - Kutty, Shelby
AU  - Kutty S
FAU - Lotz, Joachim
AU  - Lotz J
FAU - Hasenfu, Gerd
AU  - Hasenfu G
FAU - Chiribiri, Amedeo
AU  - Chiribiri A
FAU - Schuster, Andreas
AU  - Schuster A
LA  - eng
GR  - Department of Health/United Kingdom
PT  - Journal Article
PL  - United States
TA  - Invest Radiol
JT  - Investigative radiology
JID - 0045377
RN  - 0 (Contrast Media)
RN  - AU0V1LM3JT (Gadolinium)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiomyopathy, Hypertrophic/diagnostic imaging/*pathology/*physiopathology
MH  - Contrast Media
MH  - Female
MH  - Fibrosis
MH  - Gadolinium
MH  - Heart Atria/physiopathology
MH  - Heart Ventricles/diagnostic imaging/pathology/physiopathology
MH  - Humans
MH  - Hypertrophy, Left Ventricular/diagnostic imaging/*pathology/*physiopathology
MH  - Image Enhancement/methods
MH  - Magnetic Resonance Imaging/*methods
MH  - Male
MH  - Middle Aged
EDAT- 2016/10/16 06:00
MHDA- 2017/11/10 06:00
CRDT- 2016/10/15 06:00
PHST- 2016/10/16 06:00 [pubmed]
PHST- 2017/11/10 06:00 [medline]
PHST- 2016/10/15 06:00 [entrez]
AID - 10.1097/RLI.0000000000000326 [doi]
PST - ppublish
SO  - Invest Radiol. 2017 Mar;52(3):177-185. doi: 10.1097/RLI.0000000000000326.