- Poster presentation
- Open Access
Predictors of atrial emptying function in patients with hypertrophic cardiomyopathy: insights from cardiovascular magnetic resonance
© Tanacli et al; licensee BioMed Central Ltd. 2012
- Published: 1 February 2012
- Cardiovascular Magnetic Resonance
- Left Atrium
- Late Gadolinium Enhancement
- Myocardial Fibrosis
- Left Ventricular Mass Index
Atrial function is an integral part of cardiac function that is often neglected. Previous studies have shown that the left atrium (LA) is dilated and its contractile capacity is reduced in HCM patients. Whether this is related to pathophysiological aspects of HCM such as the degree of left ventricular (LV) hypertrophy, myocardial fibrosis or diastolic dysfunction remains to be established.
56 patients with HCM (44M/12F, mean age 55±14 years) and 50 normal controls (35M/15F, mean age 52±11 years) underwent CMR (Siemens Avanto 1.5T). HCM patients with reduced ejection fraction (EF<55%), known coronary artery disease, atrial fibrillation, hypertension, and moderate or severe valve disease were excluded. The imaging protocol included standard long and short-axis SSFP cines and late gadolinium enhancement (LGE) imaging. In addition to standard LV measurements (volumes, ejection fraction, mass), atrial volumes (max, min volume indexed for BSA) were measured using biplane-length-area method in 2 orthogonal planes (HLA and VLA SSFP retro-gated cine sequences). Diastolic function parameters (peak flow rate, time-to-peak-flow, deceleration time) were assessed using manual tracing of endocardial border across all temporal phases of the short axis stack and corrected for end-diastolic volume and RR interval respectively. Ventricular fibrosis was calculated using a full-width at half-maximum algorithm and expressed as LV mass percentage.
Univariate and multivariate analysis of parameters associated with left atrial ejection fraction
LV ejection fraction
LV wall thickness
Wall thickness ratio
LV Mass Index
Peak flow rate
Time to Peak Flow
Fibrosis (% of LV mass)
Atrial size is increased and function is impaired in HCM. This process is related to parameters characterizing other pathophysiological aspects of HCM including myocardial fibrosis, degree of LV hypertrophy, and LV diastolic dysfunction. In addition, age is an important contributor to LA emptying function.
Dr Tanacli is funded by Dinu Patriciu Foundation Scholarship, Ratiu Family Foundation Grant. Prof Neubauer and Dr Karamitsos acknowledge support from the Oxford National Institute for Health Research Biomedical Research Centre Programme and the British Heart Foundation.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.