Left Atrial Strain and Function in Pediatric Hypertrophic Cardiomyopathy

Left atrial (LA) strain and dysfunction are early markers of diastolic dysfunction, associated with poor exercise capacity in adults with hypertrophic cardiomyopathy (HCM). Literature on assessment of LA mechanics in pediatric HCM is lacking. The aim of this study was to assess LA strain and LA function in pediatric patients who have HCM with (phenotype positive [P+]) and without (genotype positive, phenotype negative [G+P−]) ventricular hypertrophy and evaluate their correlation with exercise stress test parameters. Seventy-eight children (3–25 years of age) with HCM (P+, n = 46; G+P−, n = 32) and 20 healthy control subjects were retrospectively studied. LA conduit function, reservoir function, and pump function were computed using phasic LA volumetric analysis. LA reservoir strain (LASr) and LA contractile strain were measured using speckle-tracking echocardiography. Exercise test findings within 12 months of echocardiography were recorded. LA conduit function (36% vs 48%, P