Prognostic value of left atrial function by cardiovascular magnetic resonance feature tracking in hypertrophic cardiomyopathy

  • Rocio HinojarEmail author
  • Jose Luis Zamorano
  • MªAngeles Fernández-Méndez
  • Amparo Esteban
  • Maria Plaza-Martin
  • Ariana González-Gómez
  • Alejandra Carbonell
  • Luis Miguel Rincón
  • Jose Julio Jiménez Nácher
  • Covadonga Fernández-Golfín
Original Paper


Left atrium (LA) size has an important role in determining prognosis and risk stratification in hypertrophic cardiomyopathy (HCM). Cardiovascular magnetic resonance myocardial feature tracking (CMR-FT) is a novel technique for the quantification of LA function. Our aim was first to evaluate LA function by CMR-FT and volumetric analysis in patients with HCM; and secondly we sought to determine the association of LA-longitudinal strain (LA-LS) with major cardiovascular outcomes, particularly all cause mortality and heart failure. 75 patients with HCM and 75 control subjects underwent a conventional CMR study including assessment of LA function by CMR-FT (LA-LS) and volumetric analysis. A primary endpoint of all-cause mortality and secondary combined endpoint of hospital admission related to heart failure, lethal ventricular arrhythmias or cardiovascular death were defined. Compared to controls, LA-LS and all volumetric indices of LA function were significantly impaired in HCM even in patients with normal LA volume and normal LV filling pressures. LA-LS showed moderate-high correlation with LA-emptying fraction (total, active and passive LA-EF, r = 0.68, r = 0.67, r = 0.31, p < 0.001 for all) and with parameters of diastolic function (E/é, r = 0.4, p < 0.001). The age, minimum LA volume and % of LGE were independent predictors of LA-LS (p < 0.01 for all). During a mean follow-up of 3.3 ± 1.2 years LA-LS was associated with the primary (HR: 0.85 (0.73–0.98), p = 0.02) and the secondary end-point (HR: 0.88 (0.82–0.96), p = 0.003). LA-LS by CMR-FT provides accurate measurements of LA function in HCM patients. LA-LS may become a novel potential predictor of poor cardiac outcomes, particularly cardiovascular mortality and HF.


Hypertrophic cardiomyopathy Cardiac magnetic resonance Left atrial strain Outcomes Heart failure 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.

Supplementary material

10554_2019_1534_MOESM1_ESM.docx (26 kb)
Supplementary material 1 (DOCX 26 KB)


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Copyright information

© Springer Nature B.V. 2019

Authors and Affiliations

  • Rocio Hinojar
    • 1
    • 2
    Email author
  • Jose Luis Zamorano
    • 1
    • 2
    • 3
  • MªAngeles Fernández-Méndez
    • 4
  • Amparo Esteban
    • 4
  • Maria Plaza-Martin
    • 1
    • 2
  • Ariana González-Gómez
    • 1
    • 2
  • Alejandra Carbonell
    • 1
    • 5
  • Luis Miguel Rincón
    • 1
    • 2
    • 3
  • Jose Julio Jiménez Nácher
    • 1
    • 2
  • Covadonga Fernández-Golfín
    • 1
    • 2
    • 3
  1. 1.Cardiology DepartmentUniversity Hospital Ramón y CajalMadridSpain
  2. 2.University AlcalaMadridSpain
  3. 3.CIBERCVInstituto de Salud Carlos III (ISCIII)MadridSpain
  4. 4.Radiology DepartmentUniversity Hospital Ramón y CajalMadridSpain
  5. 5.Cardiology DepartmentUniversity Hospital Doce de OctubreMadridSpain

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