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Atrial fibrillation in patients with hypertrophic cardiomyopathy - can speckle tracking echocardiography have additional value?

Session Poster session 3

Speaker Elzbieta Wabich

Congress : EHRA 2019

  • Topic : arrhythmias and device therapy
  • Sub-topic : Arrhythmias, General - Diagnostic Methods: Non-invasive Diagnostic Methods
  • Session type : Poster Session
  • FP Number : P1424

Authors : E Wabich (Gdansk,PL), L Danilowicz - Szymanowicz (Gdansk,PL), R Nowak (Gdansk,PL), A Zienciuk - Krajka (Gdansk,PL), K Rozwadowska (Gdansk,PL), G Raczak (Gdansk,PL)

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Authors:
E Wabich1 , L Danilowicz - Szymanowicz1 , R Nowak1 , A Zienciuk - Krajka1 , K Rozwadowska1 , G Raczak1 , 1Medical University of Gdansk, Department of Cardiology and Electrotherapy - Gdansk - Poland ,

Citation:

Background. Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM) and is associated with high risk of stroke, therefore  early diagnosis of AF is crucial. Well-known features most closely associated with paroxysmal or permanent AF include age and left atrial enlargement.
The purpose of this study was to compare the classic echocardiographic parameters as well as speckle tracking echocardiography (STE) parameters of left atrium (LA) and left ventricle (LV) in HCM patients with and without AF.

Methods. We prospectively enrolled 60 pts with HCM and 23 healthy age- and sex-matched volunteers (control group). Classic echo, as well as 2D and 3D STE parameters were assessed and compared between the groups. Additionally, the echo parameters were compared between HCM with and without AF history.

Results. HCM group had significantly worse parameters of LA size and function. Additionally, AF (+) group had significantly lower LV ejection fraction as well as LV 2D and 3D strain parameters (Table). 

Conclusions. The results of a present study confirms the worse parameters of LA size and function in the group of patients with HCM, and revealed that the presence of AF is associated with LV systolic function impairment assessed with the use of STE. This can highlight the potential role of STE techniques for  systematic screening of AF in patients with HCM.

HCM All

n=60

Healthy

volunteers

n=23

p

HCM vs

helathy

AF (-)

n=17

AF(+)

n=43

p

AF(-)

vs AF (+)

p

AF(-)

vs

helathy

p

AF(+)

vs

healthy

AGE (years)

56

(41-63)

49

(39-62)

0.268

57

(46-63)

56

(41-63)

0.381 0.160 0.287

LAA index

(cm2/BSA)

15.1

(12.4-16.3)

9.3

(8.3-10.0)

<0.0001

14.9

(12.3-16.4)

15.0

(13.4-16.0)

0.396 <0.0001 <0.0001
LAV index (ml/BSA)

52.0

(41.8-62.3)

26.7

(23.8-32.3)

<0.0001

50.7

(41.2-60.7)

58.3

(44.7-62.8

0.162 <0.0001 <0.0001
LA peak systolic strain 4Ch

15.9

(12.3-20.0)

28.5

(22.4-31.3)

<0.0001

16.5

(12.9-21.5)

13.8

(10.6-18.4)

0.164 <0.0001 <0.0001
LA peak systolic strain 2Ch

19.0

(13.6-23.1)

30.8

(27.0-32.9)

<0.0001

19.7

(14.9-23.9)

17.0

(14.9-23.9)

0.093 <0.0003 <0.0001
LVEDV (ml)

87

(67-112)

108

(89-126)

<0.025

87

(70-113)

99

(62-107)

0.389 <0.035 0.063
LVESV (ml)

28

(22-42)

40

(33-47)

<0.008

28

(21-42)

28

(26-44)

0.203 <0.008 0.062
LV ejection fraction

64

(55-69)

63

(61-63)

0.098

67

(61-70)

53

(47-64)

<0.010 <0.008 0.052
LVM index (g/BSA)

115

(110-133)

61

(55-63)

<0.0001

117

(110-135)

114

(110-119)

0.271 <0.0001 <0.0001

2D Peak systolic longitudinal

strain (%)

-15.2

(-17.5 - -12.1)

-19.6

(-20.9- - 17.9)

<0.0001

-16.3

(-19.1 - -13.9)

-12.4

(-14.2--10.0)

<0.003 <0.001 <0.0001
3D Area strain (%) -23.0 (-26.5--21.0) -26.5 (-28.8 - - 20.0) 0.109 -25.0 (-27.0- - 22.0) -19.5 (-20.8- -17.5 <0.009 0.282 <0.015
LAA- left atrial area; LAV - Left atrial volume, LA - left atrium; LV - Left ventricle; LVEDV - Left ventricular end-diastolic volume; LVESV - Left ventricular end-systolic volume, LVM - Left ventricular mass


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