Abstract
The analysis of full Left Atrium (LA) deformation and whole LA deformational trajectory in time has been poorly investigated and, to the best of our knowledge, seldom discussed in patients with Hypertrophic Cardiomyopathy. Therefore, we considered 22 patients with Hypertrophic Cardiomyopathy (HCM) and 46 healthy subjects, investigated them by three–dimensional Speckle Tracking Echocardiography, and studied the derived landmark clouds via Geometric Morphometrics with Parallel Transport. Trajectory shape and trajectory size were different in Controls versus HCM and their classification powers had high AUC (Area Under the Receiving Operator Characteristic Curve) and accuracy. The two trajectories were much different at the transition between LA conduit and booster pump functions. Full shape and deformation analyses with trajectory analysis enabled a straightforward perception of pathophysiological consequences of HCM condition on LA functioning. It might be worthwhile to apply these techniques to look for novel pathophysiological approaches that may better define atrio–ventricular interaction.
Highlights
The number of contributions aimed at modelling heart mechanics and function using image-based data increases day by day
Control mean volumetric trajectory shows a typical flattening before P–peak while it is absent in Hypertrophic Cardiomyopathy (HCM)
Controls and HCM differ for several 3D Speckle Tracking Echocardiography (3DSTE) parameters as shown in Supplementary Table 1 presented in Supplementary Online Appendix as already noted[4], especially in some of the sub–regions automatically computed by Artida device
Summary
The number of contributions aimed at modelling heart mechanics and function using image-based data increases day by day. Both Cardiac Magnetic Resonance (MRI) and 2D or 3D Speckle Tracking Echocardiography (2DSTE, 3DSTE) are used for this purpose being 2DSTE and 3DSTE less invasive, faster and of easier access. Classic 3DSTE parameters compute at any time local shape changes as differences in relation to end–systolic state. They are delivered as mean values on finite parts (segments) of the LA. In this contribution we extend the acquired knowledge of LA functional impairment in HCM by performing a deformation analysis along with a trajectory analysis, i.e. an analysis of the shape of the motion path of LA, that we hypothesize different in HCM patients versus Controls
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