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Bauer F, Shiota T, White RD, Lever HM, Qin JX, Drinko J, Martin M, Tsujino H, Sitges M, Kim YJ, Thomas JD

Determinant of left atrial dilation in patients with hypertrophic cardiomyopathy: a real-time 3-dimensional echocardiographic study.

J Am Soc Echocardiogr. 2004 Sep;17(9):968-75, PMID: 15337962

To identify the determinants of left atrial (LA) dilation for patients with hypertrophic obstructive cardiomyopathy (HOCM), first we validated LA volume determination by real-time 3-dimensional echocardiography using magnetic resonance imaging in patients. Subsequently, real-time 3-dimensional echocardiography and 2-dimensional Doppler echocardiography were performed in 60 patients with HOCM and in 17 age-matched control subjects. LA volumes and left ventricular (LV) filling pressures were higher for patients with HOCM than in control subjects. By stepwise multilinear regression analysis, LV end-diastolic pressure, resting LV outflow tract pressure gradient, and LV wall thickness were significant determinants of LA dilation. However, tau, -dP/dt, LV stiffness, provokable pressure gradient, and mitral regurgitation did not have any independent relationship with LA volumes. Therefore, it is concluded that LA volume can be accurately determined by real-time 3-dimensional echocardiography; and LA dilation in patients with HOCM is related to LV filling pressure, LV outflow tract pressure gradient, and LV wall thickness.


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