Skip to main content
Log in

Assessment of Regional Atrial Function in Patients with Hypertrophic Cardiomyopathies Using Tissue Doppler Imaging

  • Original
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

Background

This study applied tissue Doppler imaging and color tissue Doppler imaging to study atrial function changes in patients with hypertrophic cardiomyopathy (HCM). The profile of the segmental atrial velocities and the strain rate were determined and compared with those of normal matched control subjects.

Methods

This study investigated 20 patients with HCM and 20 age-matched healthy control subjects. In a four-chamber apical view, tissue Doppler imaging was used to measure the lateral left and right atrial (LA and RA) and interatrial septal (IAS) wall systolic, early, and late diastolic velocities. Similarly, the atrial strain rate during ventricular systole (SRS) and the early (SRE) and late (SRA) diastolic phases in patients and control subjects were measured. The interventricular septal tissue Doppler-derived isovolumic relaxation time was calculated.

Results

Only the IAS annular and middle segments showed a significant reduction in the early diastolic velocity (mean, 4.01 ± 2.2 vs 8.7 ± 1.1, p = 0.001; 3.23 ± 2 vs 6.01 ± 1.9, p = 0.001, respectively) for the patients with HCM in comparison with the control subjects. Generally, the atrial strain rate was clearly reduced. The systolic strain rate (SRS) was significantly reduced in the LA wall in the annular (p = 0.007) and middle (p = 0.001) segments and in the IAS middle segment (p = 0.007). Similarly, there was a reduction of the early diastolic strain rate (SRE) in the LA annular (p = 0.001) and middle (p = 0.01) segments and in the IAS annular (p = 0.05) and middle (p = 0.001) segments, as well as in the RA annular segment (p = 0.02). The RA middle segments showed insignificant changes.

Conclusion

Atrial function may be affected by HCM due to impairment of myocardial diastolic function. Strain rate imaging is reproducible, yields readily obtained parameters that provide unique data about global and longitudinal segmental atrial contraction, and can quantify the atrial dysfunction in patients with HCM.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Abraham TP, Nishimura RA, Holmes Jr, Belohlavek M, Seward JB (2002) Strain rate imaging for assessment of regional myocardial function: results from clinical model of septal ablation. Circulation 105:1403–1406

  2. Cardim N, Longo S, Pereira T, Ferreira T, Pereira A, Ramos A, Rodrigues M, Correia M (1997) Regional diastolic function in hypertrophic cardiomyopathy: a tissue Doppler echocardiographic study. Rev Port Cardiol 16:615–619, 588

    PubMed  CAS  Google Scholar 

  3. Galiuto L, Ignone G, DeMaria AN (1998) Contraction and relaxation velocities of the normal left ventricle using pulsed-wave tissue Doppler echocardiography. Am J Cardiol 81:609–614

    Article  PubMed  CAS  Google Scholar 

  4. Greenberg NL, Firstenberg MS, Castro PL, Main M, Travaglini A, Odabashian JA, Drinko JK, Rodriguez LL, Thomas JD, Garcia MJ (2002) Doppler-derived myocardial systolic strain rate is a strong index of left ventricular contractility. Circulation 105:99–105

    Article  PubMed  Google Scholar 

  5. Hoit BD, Walsh RA (1992) Regional atrial distensibility. Am J Physiol 262:H1356–H1360

    PubMed  CAS  Google Scholar 

  6. Manning WJ, Silverman DI, Katz SE (1994) Impaired left atrial mechanical function after cardioversion: relation to the duration of atrial fibrillation. J Am Coll Cardiol 23:1535–1540

    PubMed  CAS  Google Scholar 

  7. Manning WJ, Silverman DI, Katz SE, Douglas PS (1993) Atrial ejection force: a noninvasive assessment of atrial systolic function. J Am Coll Cardiol; 22:221–225

    Article  PubMed  CAS  Google Scholar 

  8. Matsuda Y, Toma Y, Ogawa H, et al. (1983) Importance of left atrial function in patients with myocardial infarction. Circulation 67:566–571

    PubMed  CAS  Google Scholar 

  9. Mattioli AV, Castelli A, Andria A, Mattioli G (1998) Clinical and echocardiographic features influencing recovery of atrial function after cardioversion of atrial fibrillation. Am J Cardiol 82:1368–1371

    Article  PubMed  CAS  Google Scholar 

  10. Pai RG, Gill KS (1998) Amplitudes, durations, and timings of apically directed left ventricular myocardial velocities: II. Systolic and diastolic asynchrony in patients with left ventricular hypertrophy. J Am Soc Echocardiogr 11:112–118

    Article  PubMed  CAS  Google Scholar 

  11. Palka P, Lange A, Fleming AD, Donnelly JE, Dutka DP, Starkey IR, Shaw TR, Sutherland GR, Fox KA (1997) Differences in myocardial velocity gradient measured throughout the cardiac cycle in patients with hypertrophic cardiomyopathy, athletes, and patients with left ventricular hypertrophy due to hypertension. J Am Coll Cardiol 30:760–768

    Article  PubMed  CAS  Google Scholar 

  12. Palka P, Lange A, Fleming AD, Sutherland GR, Fenn LN, McDicken WN (1995) Doppler tissue imaging. myocardial wall motion velocities in normal subjects. J Am Soc Echocardiogr 8:659–668

    Article  PubMed  CAS  Google Scholar 

  13. Severino S, Caso Pio, Galderisi M, De Simone L, Petrocelli A, de Divitis O, Mininni N (1998) Use of pulsed Doppler tissue imaging to assess regional left ventricular diastolic dysfunction in hypertrophic cardiomyopathy. Am J Cardiol 82:1394–1398

  14. Shively BK, Gelgand EA, Crawford MH (1996) Regional left atrial stasis during atrial fibrillation and flutter: determinants and relation to stroke. J Am Coll Cardiol 27:1722–1729

    Article  PubMed  CAS  Google Scholar 

  15. Thomas L, Levett KK, Boyd AA, Leung Dy, Schiller NB, Ross DL (2003) Changes in regional left atrial function with aging: evaluation by Doppler tissue imaging. Eur J Echocardiogr 4:92–100

    Article  PubMed  CAS  Google Scholar 

  16. Weidemann F, Eyskens B, Sutherland GR (2002) New ultrasound methods to quantify regional myocardial function in children with heart disease. Pediatr Cardiol 23:292–306

    Article  PubMed  CAS  Google Scholar 

  17. Weidemann F, Jamal F, Kowalski M, Kukulski T, D’Hooqe J, Bijnens B, De Scheerder I, Sutherland GR (2002) Can strain rate and strain quantify changes in regional systolic function during dobutamine infusion, B-blockade, and atrial pacing? Implications for quantitative stress echocardiography. J Am Soc Echocardiogr 15:416–424

    Article  PubMed  Google Scholar 

  18. Weidemann F, Mertens L, Gewillig M, Sutherland GR (2001) Quantitation of localized abnormal deformation in asymmetric nonobstructive hypertrophic cardiomyopathy: a velocity, strain rate, and strain Doppler myocardial imaging study. Pediatr Cardiol 22:534–537

    Article  PubMed  CAS  Google Scholar 

  19. Wigle ED, Saason Z, Henderson MA, Ruddy TD,Williams WG (1985) Hypertrophic cardiomyopathy: the importance of the site and the extent of hypertrophy: a review. Prog Cardiovasc Dis 28:1–83

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgment

We are grateful to Anne M. Gale, ELS, of the Deutsches Herzentrum Berlin for editorial assistance.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ragiab Telagh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Telagh, R., Hui, W., Abd El Rahman, M. et al. Assessment of Regional Atrial Function in Patients with Hypertrophic Cardiomyopathies Using Tissue Doppler Imaging. Pediatr Cardiol 29, 301–308 (2008). https://doi.org/10.1007/s00246-007-9112-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-007-9112-0

Keywords

Navigation