Left atrial mechanical function and clinical performance in non-dilated versus dilated cardiomyopathy

SEÇKİN Ö., ÜNLÜ S., Aydogdu G. T.

POSTGRADUATE MEDICINE, cilt.137, sa.7, ss.709-717, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 137 Sayı: 7
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1080/00325481.2025.2573625
  • Dergi Adı: POSTGRADUATE MEDICINE
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, CINAHL, EBSCO Education Source, Educational research abstracts (ERA), International Pharmaceutical Abstracts, Veterinary Science Database
  • Sayfa Sayıları: ss.709-717
  • Anahtar Kelimeler: 6-minute walk test, conduit function, dilated cardiomyopathy, left atrial strain, Non-dilated left ventricular cardiomyopathy, speckle-tracking echocardiography
  • Gazi Üniversitesi Adresli: Evet

Özet

BackgroundNon-dilated left ventricular cardiomyopathy (NDLVC) is a distinct entity characterized by impaired left ventricular ejection fraction despite normal chamber dimensions. While it may represent an earlier or less fibrotic stage of non-ischemic cardiomyopathy compared to dilated-cardiomyopathy (DCM), its clinical and structural characterization remains incomplete.ObjectivesThis study aimed to compare left atrial (LA) phasic strain parameters between patients with NDLVC and those with DCM, all with similarly reduced ejection fractions. Additionally, the relationship between LA function and exercise capacity was assessed using the 6-minute walk test (6MWT).MethodsIn this prospective, observational study, 83 patients with non-ischemic systolic dysfunction were enrolled(NDLVC:n = 51; DCM:n = 32). All underwent comprehensive transthoracic echocardiography, including LA strain analysis (reservoir, conduit, contractile phases) using speckletracking imaging. Functional capacity was evaluated via 6MWT.ResultsPatients with NDLVC exhibited significantly higher LA reservoir and conduit strain values than those with DCM. Among all echocardiographic parameters, LA conduit strain showed the strongest correlation with 6MWT distance (r = 0.42, p = 0.002) and was the only independent predictor of functional capacity in multivariable analysis.ConclusionsLA conduit strain is a promising noninvasive parameter for identifying functional and structural differences between NDLVC and DCM. Its strong association with exercise capacity and ability to differentiate phenotypes may support its integration into clinical assessment and follow up,particularly in clarifying structural and functional differences in non-ischemic remodeling patterns. These findings suggest that preserved LA conduit function in NDLVC may reflect a less hemodynamically burdened atrial profile, which is consistent with better clinical performance and functional capacity.