Characterization of left atrial dysfunction in hypereosinophilic syndrome – Insights from the Motion analysis of the heart and great vessels by three-dimensional speckle tracking echocardiography in pathological cases (MAGYAR-Path) Study

Abstract

Introduction: The present study was designed to compare three-dimensional speckle tracking echocardiography (3DSTE)-derived left atrial (LA) volumetric, volume-based functional and strain parameters between patients with hypereosinophilic syndrome (HES) and matched controls. Methods: A total of 10 HES patients and 19 age- and gender-matched healthy controls were included in the study. Complete two-dimensional Doppler echocardiography and 3DSTE were performed in all HES cases and controls. Results: Significantly increased maximum (72.9±38.8 ml vs. 45.6±15.5 ml, p=0.01) and minimum (46.3±33.3 ml vs. 26.0±15.0 ml, p=0.03) LA volumes and LA volume before atrial contraction (62.0±36.0 ml vs. 36.5±16.6 ml, p=0.01) were found in HES patients compared to controls. Both peak global (18.3±6.7% vs. 25.6±9.0%, p=0.03) and mean segmental (22.2±6.0% vs. 31.0±12.1%, p=0.04) circumferential strains were significantly reduced in HES patients, suggesting decreased LA reservoir function. Conclusion: Increased LA volumes can be demonstrated in HES patients, accompanied by reduced LA peak circumferential strain as assessed by 3DSTE, suggesting LA remodeling. Resumo: Introdução: O presente estudo foi concebido para comparar parâmetros volumétricos auriculares esquerdos derivados por ecocardiografia tridimensional speckle tracking, parâmetros funcionais e strain baseados no volume entre doentes com síndrome hipereosinofílica e controlos equiparados. Métodos: Um total de dez doentes HES e de 19 controlos saudáveis, equiparados para idade e género, foram incluídos no estudo. O estudo completo ecocardiográfico bidimensional, Doppler e 3DSTE, foi realizado em todos os casos HES e controlos. Resultados: Encontrou-se em doentes com HES, comparativamente com os controlos, um aumento significativo dos volumes auriculares esquerdos (72,9 ± 38,8 ml versus 45,6 ± 15,5 ml, p = 0,01), mínimo (46,3 ± 33,3 ml versus 26,0 ± 15,0 ml, p = 0,03) e volume auricular esquerdo antes da contração auricular (62,0 ± 36,0 ml versus 36,5 ± 16,6 ml, p = 0,01). Ambos strains circunferenciais pico, global (18,3 ± 6,7% versus 25,6 ± 9,0%, p = 0,03) e segmentar médio (22,2 ± 6,0% versus 31,0 ± 12,1%, p = 0,04) eram significativamente reduzidos em doentes HES, sugerindo diminuição de função auricular esquerda de reservatório. Conclusão: O aumento de volumes auriculares esquerdos foi demonstrado nos doentes HES, sendo acompanhado por redução de strain circunferencial pico da aurícula esquerda conforme avaliado por 3DSTE, sugerindo remodelagem auricular esquerda. Keywords: Echocardiography, Function, Left atrium, Three-dimensional, Two-dimensional, Speckle tracking, Palavras-chave: Ecocardiografia, Função, Aurícula esquerda, Tridimensional, Bidimensional, Speckle-tracking