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Erschienen in: The International Journal of Cardiovascular Imaging 7/2019

21.02.2019 | Original Paper

Left atrial fibrosis correlates with extent of left ventricular myocardial delayed enhancement and left ventricular strain in hypertrophic cardiomyopathy

verfasst von: Syed R. Latif, Vinh Q. Nguyen, Dana C. Peters, Aaron Soufer, Mariana L. Henry, Karl Grunseich, Jeffrey Testani, David J. Hur, Steffen Huber, Hamid Mojibian, Demetrius Dicks, Albert J. Sinusas, Judith L. Meadows, Nikolaos Papoutsidakis, Daniel Jacoby, Lauren A. Baldassarre

Erschienen in: The International Journal of Cardiovascular Imaging | Ausgabe 7/2019

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Abstract

Hypertrophic cardiomyopathy (HCM) is associated with increased left ventricular (LV) mass, decreased myocardial strain, and the presence of LV fibrosis and scar. The relationship between LV scar and fibrosis with left atrial (LA) fibrosis in the setting of HCM has not been examined. The purpose of this study is to demonstrate a correlation between the degree of LA fibrosis and LV parameters in subjects with HCM. Twenty-eight subjects with HCM were imaged on a 1.5T MRI scanner with cine, LV and LA late gadolinium enhancement (LGE) sequences. LA LGE and LA measurements were correlated with LV measurements of volumes, mass, strain, and LGE. Other clinical conditions and medication usage were also examined and evaluated for correlation with LA and LV parameters. LV LGE was identified in 24 (86%) of the cases and LA LGE was identified in all of the cases. Extent of LA fibrosis significantly correlated with percent LV LGE (r = 0.64, p = 0.001), but not with indexed LV mass or maximum wall thickness. Extent of LA fibrosis also moderately correlated with decreased LV global strain (radial, r = − 0.50, p = 0.013; circumferential, r = 0.47, p = 0.02; longitudinal, r = 0.52, p = 0.013). Increased LA systolic volume correlated moderately with LV end diastolic volume (r = 0.50, p = 0.006). Patients on therapy with Renin-Angiotensin-Aldosterone System (RAAS) Inhibition had significantly less LA LGE compared to those without (18.6% vs 10.8%, p = 0.023). LA fibrosis, as measured by LGE, is prevalent in HCM and is correlated with LV LGE. The correlation between LA and LV LGE might suggest either that LA fibrosis is a consequence of LV remodeling, or that LA and LV fibrosis are both manifestations of the same cardiomyopathic process. Further study is warranted to determine the causality of LA scar in this population.
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Metadaten
Titel
Left atrial fibrosis correlates with extent of left ventricular myocardial delayed enhancement and left ventricular strain in hypertrophic cardiomyopathy
verfasst von
Syed R. Latif
Vinh Q. Nguyen
Dana C. Peters
Aaron Soufer
Mariana L. Henry
Karl Grunseich
Jeffrey Testani
David J. Hur
Steffen Huber
Hamid Mojibian
Demetrius Dicks
Albert J. Sinusas
Judith L. Meadows
Nikolaos Papoutsidakis
Daniel Jacoby
Lauren A. Baldassarre
Publikationsdatum
21.02.2019
Verlag
Springer Netherlands
Erschienen in
The International Journal of Cardiovascular Imaging / Ausgabe 7/2019
Print ISSN: 1569-5794
Elektronische ISSN: 1875-8312
DOI
https://doi.org/10.1007/s10554-019-01551-7

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