الفهرس 
INTRODUCTION & AIM OF THE WORKOnly 14 pages are availabe for public view
 |  | from | 141 |  |  |
| | | from | 141 | | |
Abstract
Hypertrophic cardiomyopathy(HCM) represents a generalized myopathic process affecting both ventricular &atrial myocardium. We assessed the global and regional left atrial(LA) function and its relation to left ventricular(LV) mechanics and clinical status in patients with HCM using Vector Velocity Imaging(VVI). Methods: VVI of LA& LV was acquired from apical 4& 2 chamber views in 108 HCM patient (age 40±19years, 56.5% men) and 33 healthy subjects, all had normal LV systolic function. The LA subendocardium was traced to obtain atrial volumes, ejection fraction, velocities, and strain (ɛ)/strain rate (SR) measurements. Results: LA reservoir (ɛsys,SRsys) and conduit (early diastolic SRe) function were significantly reduced in HCM compared to controls(P<.0001). LA deformation directly correlated to LVɛsys, SRsys and negatively correlated to age, NYHA class, LVOT gradient, LVMI, LA volume index and severity of mitral regurge(P<0.001). ROC curve was constructed to explore the cutoff value of LA deformation in differentiation of LA dysfunction; ɛsys <40% was 75% sensitive, 50% specific, SRsys<1.7s-1 was 70% sensitive, 61 % specific, SRe>-1.8s-1 was 81% sensitive &30% specific, SRa>-1.5s-1 was 73% sensitive and 40% specific. By multivariate analysis global LVɛsys and LV septal thickness are independent predictors for LAɛsys, while end systolic diameter is the only independent predictor for SRsys, P<.001.