Abstract #0359

Prognostic Utility of Left Atrial Strain to Predict Atrial Fibrillation in Hypertrophic Cardiomyopathy: Insights from the NHLBI HCM Registry

Owen P Agnel¹, Niklas Beyhoff¹, Maximilian Fenski¹, Christina Botrous¹, Yi Jie Gifford Tan¹, Robert W Smillie¹, Hugh C Watkins¹, William S Weintraub², Raymond Y Kwong³, Michael Jerosch-Herold³, Carolyn Y Ho³, Milind Y Desai⁴, Patrice Desvigne-Nickens⁵, Dong-Yun Kim⁵, Sarahfaye F Dolman², Johan F Brekke⁶, John P DiMarco⁷, Paul Kolm², Christopher M Kramer⁷, Stefan Neubauer¹, and Betty Raman¹

¹Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, United Kingdom, ²MedStar Heart and Vascular Institute, Washington, DC, United States, ³Cardiovascular Division, Department of Medicine and Department of Radiology, Brigham and Women's Hospital, Boston, MA, United States, ⁴Cardiovascular Institute, Cleveland Clinic, Cleveland, OH, United States, ⁵National Heart, Lung, and Blood Institute, Bethesda, MD, United States, ⁶Cytokinetics, South San Francisco, CA, United States, ⁷Cardiovascular Division, University of Virginia Health System, Charlottesville, VA, United States

Synopsis

Keywords: Myocardium, Cardiomyopathy, Hypertrophic Cardiomyopathy, Left Atrial Strain, Atrial Fibrillation

Motivation: Atrial fibrillation (AF) is a major driver of morbidity and mortality in hypertrophic cardiomyopathy (HCM). Single centre evidence suggested that left atrial (LA) strain may be used to identify patients at risk of AF.

Goal(s): This study aimed to determine the prognostic utility of LA strain to predict new AF events in the world’s largest HCM registry.

Approach: Cardiovascular magnetic resonance data of 1,661 HCM patients was used to derive an optimal LA strain threshold, which was then validated in an independent cohort.

Results: LA reservoir strain was identified as an independent predictor of AF, providing prognostic information beyond established risk factors.

Impact: Our findings suggest that left atrial (LA) strain is an independent predictor of atrial fibrillation in patients with hypertrophic cardiomyopathy. Assessment of LA strain may thus improve prognostic risk assessment and clinical management in the future.

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