Four-Chamber Deformation Remodeling and Atrial Fibrillation After Septal Myectomy for Obstructive Hypertrophic Cardiomyopathy.

Authors

Olga N Kislitsina, Lubna Choudhury, Kifah Hussain, James D Thomas, Seokyung An, Abigail S Baldridge, Daniel J Romary, Beth Whippo, James L Cox, Patrick M McCarthy, Douglas R Johnston

Published in

Echocardiography (Mount Kisco, N.Y.). Volume 43. Issue 8. Pages e70567.

Abstract

Septal myectomy treats hypertrophic obstructive cardiomyopathy (HOCM), but its effect on myocardial deformation across cardiac chambers is incompletely defined. We evaluated chamber-specific strain remodeling 1 year after septal myectomy and examined whether atrial strain was associated with atrial fibrillation (AF) during follow-up.
We retrospectively studied 187 consecutive patients undergoing surgical septal myectomy for HOCM. Conventional echocardiography and speckle-tracking strain analysis were used to assess left ventricular (LV), right ventricular (RV), left atrial (LA), and right atrial (RA) deformation preoperatively and at 1-year follow-up. Paired analyses compared preoperative and postoperative strain values. Multivariable logistic regression evaluated associations between baseline strain measures, AF, and all-cause mortality.
Among 187 patients, 85 had analyzable 1-year strain studies. At 1 year, LA contractile strain (CS) improved from 10.4±5.9% to 13.6±7.1% (p = 0.005), whereas LA reservoir strain (RS) did not significantly change. In contrast, RA-RS decreased from 36.0±10.6% to 28.0±11.6% (p = 0.001), RV free-wall strain worsened from -26.3±7.0% to -21.1±6.8% (p = 0.001), and RV global longitudinal strain (GLS) worsened from -21.3±5.1% to -17.3±5.5% (p = 0.001). LV-GLS was unchanged. Higher LA-CS was associated with lower odds of AF after adjustment (aOR 0.92, 95% CI 0.85-0.99; p = 0.018), as was higher LA-RS (aOR 0.95, 95% CI 0.91-0.99; p = 0.035). LA-RS was associated with mortality in unadjusted analysis but not after multivariable adjustment.
Septal myectomy is followed by nonuniform, chamber-specific deformation remodeling. LA-CS improves, LA-RS and CS identify patients at higher AF risk, LV-GLS remains unchanged, and right-sided longitudinal deformation worsens at 1 year. Four-chamber strain analysis may augment post-myectomy surveillance.

PMID:
42518120
Bibliographic data and abstract were imported from PubMed on 28 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.