Impact of left atrial strain mechanics on exercise intolerance and need for septal reduction therapy in hypertrophic cardiomyopathy
| Autor: | Per Wierup, Maran Thamilarasan, Nicholas G. Smedira, Richard A. Grimm, Milind Y. Desai, Bo Xu, Maria Vega Brizneda, Yoshihito Saijo, Zoran B. Popović, Harry M. Lever, Brian P. Griffin, Erik H. Van Iterson |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Ventricular outflow tract obstruction Strain (injury) Speckle tracking echocardiography Exercise intolerance 030204 cardiovascular system & hematology 03 medical and health sciences Ventricular Dysfunction Left 0302 clinical medicine Internal medicine medicine Humans Radiology Nuclear Medicine and imaging 030212 general & internal medicine Heart Atria Reduction (orthopedic surgery) Aged business.industry Hypertrophic cardiomyopathy General Medicine Cardiomyopathy Hypertrophic Middle Aged medicine.disease Quartile Echocardiography Cohort Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Echocardiography Stress |
| Zdroj: | European heart journal. Cardiovascular Imaging. 23(2) |
| ISSN: | 2047-2412 |
| Popis: | Aims We sought to assess the relationship between left atrial (LA) strain mechanics and exercise intolerance, and to evaluate the prognostic impact of LA strain mechanics on clinical deterioration necessitating septal reduction therapy in hypertrophic cardiomyopathy (HCM). Methods and results Consecutive HCM patients who underwent exercise stress echocardiography and cardiopulmonary exercise testing on the same day between October 2015 and April 2019 were enrolled prospectively. LA strain mechanics were analysed using speckle tracking echocardiography. LA stiffness was calculated as the ratio of E/e′ ratio to LA reservoir strain. The study cohort was divided into four groups based on the quartile of percent-predicted peak VO2, and exercise intolerance was defined as the lowest quartile (≤51%). Of 532 patients studied (mean age: 51 ± 15 years, 42% female), 138 patients demonstrated exercise intolerance. As exercise capacity worsened, LA strain mechanics worsened along a continuum (P Conclusion Worse LA contractile strain was an independent predictor for exercise intolerance in HCM. Patients with worse LA stiffness had a higher probability of clinical deterioration necessitating septal reduction therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|