Left atrial myocardial function in either physiological or pathological left ventricular hypertrophy: a two-dimensional speckle strain study

• Published in: British journal of sports medicine 2008-08, Vol.42 (8), p.696-702
• Main Authors: D’Andrea, A, De Corato, G, Scarafile, R, Romano, S, Reigler, L, Mita, C, Allocca, F, Limongelli, G, Gigantino, G, Liccardo, B, Cuomo, S, Tagliamonte, G, Caso, P, Calbrò, R
• Format: Article
• Language: English
• Subjects: Adult; Analysis of Variance; Athletes; Atrial Function, Left - physiology; Blood pressure; Cardiovascular disease; Case-Control Studies; Echocardiography - methods; Echocardiography - standards; Exercise; Exercise Test - methods; Heart; Heart attacks; Heart Rate - physiology; Humans; Hypertension - complications; Hypertension - diagnostic imaging; Hypertension - physiopathology; Hypertrophy, Left Ventricular - diagnostic imaging; Hypertrophy, Left Ventricular - etiology; Hypertrophy, Left Ventricular - physiopathology; Male; Multivariate analysis; Sports - physiology; Stress; Studies
• ISSN: 0306-3674; 1473-0480
• DOI: 10.1136/bjsm.2007.041210

Background:Atrial function is an integral part of cardiac function that is often neglected. The presence of left ventricule hypertrophy (LVH) due to arterial hypertension may impair atrial function. However, it has also been suggested that physical training attenuates the age-associated impairment of diastolic filling. This study investigated whether mechanical dysfunction in the left atrium (LA) is present in patients with either physiological or pathological LVH, using two-dimensional strain rate imaging (2D strain echocardiography; 2DSE).Methods:Standard echocardiography, exercise stress echo and 2DSE of the left atrium were performed in 40 patients with arterial hypertension, 45 age-matched elite athletes (>40 years) and 25 healthy sedentary controls. Atrial longitudinal strain was performed from the apical views for the basal segments of the LA septum, lateral wall and roof.Results:LV mass index and ejection fraction were comparable between patients with either physiological or pathological LVH. Elite athletes showed increased LV end-diastolic diameter, end-diastolic volume and stroke volume, whereas circumferential end-systolic stress was higher in patients with hypertension. LA diameter and maximum volume were increased but similar between the two groups of patients with LVH. LA active emptying volume and fraction were both higher in patients with hypertension. Conversely, peak systolic myocardial atrial strain was significantly reduced in patients with pathological LVH compared with controls and athletes for all the analysed atrial segments (p