scholarly journals What is the Role of Two-Dimensional Speckle Tracking Echocardiography in the Diagnosis and Management of Anthracycline-Induced Cardiotoxicity?

2018 ◽  
Author(s):  
Isabela Bispo Santos da Silva Costa ◽  
Ludhmila Abrahão Hajjar
Keyword(s):  
Speckle Tracking ◽  
Speckle Tracking Echocardiography ◽  
Two Dimensional ◽  
Diagnosis And Management

scholarly journals The Role of Left-Atrial Mechanics Assessed by Two-Dimensional Speckle-Tracking Echocardiography to Differentiate Hypertrophic Cardiomyopathy from Hypertensive Left-Ventricular Hypertrophy

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 814
Author(s):  
Nicoleta-Monica Popa-Fotea ◽  
Miruna Mihaela Micheu ◽  
Nicoleta Oprescu ◽  
Adriana Alexandrescu ◽  
Maria Greavu ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Ventricular Hypertrophy ◽  
Speckle Tracking Echocardiography ◽  
Left Ventricular ◽  
Two Dimensional ◽  
Booster Pump ◽  
Conduit Function

Hypertrophic cardiomyopathy (HCM) and arterial hypertension (HTN) are conditions with different pathophysiology, but both can result in left-ventricular hypertrophy (LVH). The role of left-atrial (LA) functional changes detected by two-dimensional speckle-tracking echocardiography (STE) in indicating LVH etiology is unknown. Methods: We aimed to characterize LA mechanics using STE in LVH patients with HCM and HTN. LA 2D volumetric and STE parameters were analyzed in 86 LVH patients (43 HCM and 43 isolated HTN subjects) and 33 age- and sex-matched controls. Results: The volumetric study showed that LA reservoir and conduit function were impaired in the HCM group compared to controls, while, in the HTN group, only LA conduit function was deteriorated. The HCM group had all three STE-derived LA functions impaired compared to controls. The HTN group, consistently with volumetric analysis, had solely LA conduit function reduced compared to controls. Ratios of LA booster-pump strain (S) and strain rate (SR) to interventricular septum (IVS) thickness were the most accurate parameters to discriminate between HCM and HTN. The subgroup harboring sarcomeric pathogenic (P)/likely pathogenic (LP) variants had reduced LA booster-pump S and SR compared with the genotype-negative subgroup. Conclusions: LA reservoir, conduit, and pump functions are decreased in HCM compared to HTN patients with similar LVH. We report the ratios between LA contraction S/SR and IVS thickness as novel parameters with high accuracy in discriminating LVH due to HCM. The presence of P/LP variants in sarcomeric or sarcomeric-associated genes could be associated with more severe LA dysfunction.

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