Analysis of the left atrial function using two-dimensional strain in
patients with recent diagnosis of hereditary hemochromatosis
Abstract
Background. Hereditary Hemochromatosis (HH) is a genetic condition
associated with a systemic iron overload. Heart failure is an important
cause of mortality. It has been demonstrated early stages of systolic
and diastolic left ventricular dysfunction in previous studies. The aim
of the study is to compare the left atrial (LA) function between
asymptomatic HH patients and a control group using 2D speckle tracking.
Methods. Prospective study. LA strain, LA strain rate and LA volumetric
parameters during the reservoir, conduit and contraction phases were
studied. The LA Stiffness Index was calculated by the ratio between E/e
and LA reservoir strain. Results. 30 patients with HH (90% males, 47 ±
18 years old) and 30 healthy controls (85% males, 45 ± 13 years old)
were included. LA volume was similar in both groups. No differences were
observed in LA ejection fraction (EF), LA passive EF and LA active
ejection fraction between both groups. On the contrary, the HH group had
lower LA strain during the reservoir (31.5 ± 6.5% vs 38.3 ± 7.9%;
p=0.002), and conduit phases (-18 ± 7% vs -23.3 ± 6.4%; p=0.01) and
lower LA conduit strain rate (-1.7 ± 0.7 seg-1 vs -2.1 ± 0.5 seg-1;
p=0.02) than controls. The LA stiffness index was significantly higher
in the HH group (0.25 ± 0.9 vs 0.19 ± 0.6; p=0.01). Conclusions. Early
abnormalities in the LA function could be detected by using 2D speckle
tracking study despite no evidence of changes in atrial size or
volumetric parameters.