Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Original Article

Volume 15, Number 5, October 2024, pages 396-403

Detection of Left Atrial Remodeling by Three-Dimensional Echocardiography in Symptomatic Patients Known to Had Non-Obstructive Hypertrophic Cardiomyopathy

Figure 3. LA peak strain at reservoir, conduit and contractile functions by 2D speckle tracking echo. LA: left atrial.

Figure 4. Correlation between IVSD and (a) E/e, (b) PAP, (c) LVGLS, (d) Vmax indexed, and (e) Vmax. IVSD: interventricular septal dimeter in diastole; LVGLS: LV global longitudinal strain; PAP: pulmonary artery pressure; Vmax: maximum LA volume; Vmax indexed: indexed maximum LA volume.

**Table 1.** General Characteristics of Studied Groups
	Patients (n = 170)	Controls (n = 30)	P-value
Data are presented as mean ± SD or number (%). *Significant P-value. BMI: body mass index; BSA: body surface area; SD: standard deviation.
Age (years)	35 ± 10	28 ± 5	< 0.001*
Sex
Male	90 (52.9)	16 (53.3)	0.782
Female	80 (47.05)	14 (46.7)
BMI	27.6 ± 1.6	27.2 ± 1	0.201
BSA	1.76 ± 0.09	1.76 ± 0.11	0.910

Table 1. General Characteristics of Studied Groups

Patients (n = 170)

Controls (n = 30)

P-value

Data are presented as mean ± SD or number (%). *Significant P-value. BMI: body mass index; BSA: body surface area; SD: standard deviation.

Age (years)

35 ± 10

28 ± 5

< 0.001*

Sex

Male

90 (52.9)

16 (53.3)

0.782

Female

80 (47.05)

14 (46.7)

BMI

27.6 ± 1.6

27.2 ± 1

0.201

BSA

1.76 ± 0.09

1.76 ± 0.11

0.910

**Table 2.** 2D Echo Doppler Dimensions of Studied Cases
	Dimensions
Data are presented as mean ± SD. 2D: two-dimensional; 3D: three-dimensional; LVEDD: left ventricular end-diastolic dimension; LVESD: left ventricular end-systolic dimension; IVSD: interventricular septal dimeter in diastole; IVSS: interventricular septal dimeter in systole; LVMI: LV mass index; LVPWDS: LV posterior wall dimeter in systole; LVPWDD: LV posterior wall dimeter in diastole; AROD: aortic root dimension; LA: left atrial; PG: pressure gradient; SD: standard deviation.
LVEDD	45 ± 4
LVESD	27 ± 5
IVSD	33 ± 7
IVSS	36 ± 6
LVMI (3D echo)	98 ± 8
LVPWDS	13 ± 1
LVPWDD	10 ± 1
AORD	26 ± 3
LA dimension	43 ± 4
PG resting	10 ± 1
PG Valsalva	13 ± 2

Table 2. 2D Echo Doppler Dimensions of Studied Cases

Dimensions

Data are presented as mean ± SD. 2D: two-dimensional; 3D: three-dimensional; LVEDD: left ventricular end-diastolic dimension; LVESD: left ventricular end-systolic dimension; IVSD: interventricular septal dimeter in diastole; IVSS: interventricular septal dimeter in systole; LVMI: LV mass index; LVPWDS: LV posterior wall dimeter in systole; LVPWDD: LV posterior wall dimeter in diastole; AROD: aortic root dimension; LA: left atrial; PG: pressure gradient; SD: standard deviation.

LVEDD

45 ± 4

LVESD

27 ± 5

IVSD

33 ± 7

IVSS

36 ± 6

LVMI (3D echo)

98 ± 8

LVPWDS

13 ± 1

LVPWDD

10 ± 1

AORD

26 ± 3

LA dimension

43 ± 4

PG resting

10 ± 1

PG Valsalva

13 ± 2

**Table 3.** PAP and EF in Studied Groups
	Patients (n = 170)	Controls (n = 30)	P-value
Data are presented as mean ± SD. *Significant P-value. PAP: pulmonary artery pressure; EF: ejection fraction; SD: standard deviation.
PAP (mm Hg)	42 ± 7	27 ± 4	< 0.001*
EF by Simpsons	66 ± 4	65 ± 4	0.223

Table 3. PAP and EF in Studied Groups

Patients (n = 170)

Controls (n = 30)

P-value

Data are presented as mean ± SD. *Significant P-value. PAP: pulmonary artery pressure; EF: ejection fraction; SD: standard deviation.

PAP (mm Hg)

42 ± 7

27 ± 4

< 0.001*

EF by Simpsons

66 ± 4

65 ± 4

0.223

**Table 4.** 3D LA Volumetric Indices of Studied Groups
	Patients (n = 170)	Controls (n = 30)	P-value
Data are presented as mean ± SD. *Significant P-values. 3D: three-dimensional; LA: left atrial; Vmax: maximum LA volume; Vmax indexed: indexed maximum LA volume; Vmin: minimum LA volume; Vpre-A: pre-LA contraction volume; LAEF: left atrium ejection fraction; LASr: left atrial strain at reservoir function; LAScd: left atrial strain at conduit function; LASct: left atrial strain at contractile function; SD: standard deviation.
Vmax	80 ± 9	50 ± 5	< 0.001*
Vmax indexed	43.5 ± 5.6	28.7 ± 3.7	< 0.001*
Vmin	56 ± 10	30 ± 4	< 0.001*
Vpre-A	69 ± 10	41 ± 6	< 0.001*
Total LAEF	33 ± 5	45 ± 4	< 0.001*
LASr	24 ± 4	41 ± 3	< 0.001*
LAScd	-13 ± 2	-24 ± 2	< 0.001*
LASct	-11 ± 2	-18 ± 1	< 0.001*

Table 4. 3D LA Volumetric Indices of Studied Groups

Patients (n = 170)

Controls (n = 30)

P-value

Data are presented as mean ± SD. *Significant P-values. 3D: three-dimensional; LA: left atrial; Vmax: maximum LA volume; Vmax indexed: indexed maximum LA volume; Vmin: minimum LA volume; Vpre-A: pre-LA contraction volume; LAEF: left atrium ejection fraction; LASr: left atrial strain at reservoir function; LAScd: left atrial strain at conduit function; LASct: left atrial strain at contractile function; SD: standard deviation.

Vmax

80 ± 9

50 ± 5

< 0.001*

Vmax indexed

43.5 ± 5.6

28.7 ± 3.7

< 0.001*

Vmin

56 ± 10

30 ± 4

< 0.001*

Vpre-A

69 ± 10

41 ± 6

< 0.001*

Total LAEF

33 ± 5

45 ± 4

< 0.001*

LASr

24 ± 4

41 ± 3

< 0.001*

LAScd

-13 ± 2

-24 ± 2

< 0.001*

LASct

-11 ± 2

-18 ± 1

< 0.001*

**Table 5.** PW Transmitral Inflow and Tissue Doppler E/e’ in Studied Groups
	Patients (n = 170)	Controls (n = 30)	P-value
Data are presented as mean ± SD. *Significant P-values. PW: pulsed wave; SD: standard deviation.
Peak E wave	0.93 ± 0.12	0.96 ± 0.12	0.254
Peak A wave	0.58 ± 0.09	0.94 ± 0.11	< 0.001*
E/e’ ratio	17.3 ± 4.3	8 ± 1	< 0.001*

Table 5. PW Transmitral Inflow and Tissue Doppler E/e’ in Studied Groups

Patients (n = 170)

Controls (n = 30)

P-value

Data are presented as mean ± SD. *Significant P-values. PW: pulsed wave; SD: standard deviation.

Peak E wave

0.93 ± 0.12

0.96 ± 0.12

0.254

Peak A wave

0.58 ± 0.09

0.94 ± 0.11

< 0.001*

E/e’ ratio

17.3 ± 4.3

8 ± 1

< 0.001*

**Table 6.** Speckle Tracking Parameters in Studied Groups
	Patients (n = 170)	Controls (n = 30)	P-value
Data are presented as mean ± SD. *Significant P-values. LVGLS: LV global longitudinal strain; pLASRr: peak LA strain at reservoir function; pLASRcd: peak LA strain at conduit function; pLASRct: peak LA strain at contractile function; SD: standard deviation.
LVGLS	-15 ± 1.4	22.5 ± 2	< 0.001*
pLASRr	26 ± 4	43 ± 3	< 0.001*
pLASRcd	-14 ± 2	-25 ± 2	< 0.001*
pLASRct	-12 ± 2	-18 ± 1	< 0.001*

Table 6. Speckle Tracking Parameters in Studied Groups

Patients (n = 170)

Controls (n = 30)

P-value

Data are presented as mean ± SD. *Significant P-values. LVGLS: LV global longitudinal strain; pLASRr: peak LA strain at reservoir function; pLASRcd: peak LA strain at conduit function; pLASRct: peak LA strain at contractile function; SD: standard deviation.

LVGLS

-15 ± 1.4

22.5 ± 2

< 0.001*

pLASRr

26 ± 4

43 ± 3

< 0.001*

pLASRcd

-14 ± 2

-25 ± 2

< 0.001*

pLASRct

-12 ± 2

-18 ± 1

< 0.001*

**Table 7.** Correlation Between IVSD and Other Parameters
	IVSD
r: correlation coefficient. *Significant P-values. IVSD: interventricular septal dimeter in diastole; LVGLS: LV global longitudinal strain; PAP: pulmonary artery pressure; Vmax: maximum LA volume; Vmax indexed: indexed maximum LA volume.
E/e ratio	0.513	< 0.001*
PAP	0.903	< 0.001*
LVGLS	-0.754	< 0.001*
Vmax indexed	0.806	< 0.001*
Vmax	0.859	< 0.001*

Table 7. Correlation Between IVSD and Other Parameters

IVSD

r: correlation coefficient. *Significant P-values. IVSD: interventricular septal dimeter in diastole; LVGLS: LV global longitudinal strain; PAP: pulmonary artery pressure; Vmax: maximum LA volume; Vmax indexed: indexed maximum LA volume.

E/e ratio

0.513

< 0.001*

PAP

0.903

< 0.001*

LVGLS

-0.754

< 0.001*

Vmax indexed

0.806

< 0.001*

Vmax

0.859

< 0.001*