Nihoyannopoulos, PetrosAlanazi, Amirah2023-11-302023-11-302023-11-01https://hdl.handle.net/20.500.14154/69989Introduction: LVH is present in 15% to 20% of the general population. Development of LVH leads to a reduction of chamber compliance and increased stiffness coupled with a reduction of ventricular volume and suction, play a role in the pathophysiology of diastolic dysfunction which is directly exposed to Left Atrium which is a very sensitive marker in patients with hypertrophic left ventricle. LA STE has shown a promising method for assessing LA function components including reservoir, conduit, and contractile strain. In this project we aim to assess the severity of impairment of the LA function and to evaluate the correlations among the various forms of LVH including Aortic Stenosis, Hypertrophic Cardiomyopathy, Hypertension and Cardiac Amyloidosis. Methods: The study includes a total of 70 LVH patients were assessed in the echocardiography department at Hammersmith hospital. Hypertension (n=23), Aortic stenosis (n=21), Hypertrophic cardiomyopathy (n=23) and (n=3) for Cardiac Amyloidosis A comprehensive transthoracic echocardiographic assessment were performed. Standard 2D and Doppler measures were made including maximum LA volume indexed to BSA, transmitral early (E) and late (A) velocities, E/A ratio, Septal and lateral annular e’ velocity, E/e’ ratio and LA. LV EF% and dimensions diameter were derived. The LA speckle tracking, and LV GLS was performed by using TOMTEC-ARENA software. SPSS software was used for Statistical analysis. Results: Among all the groups most of left ventricular diastolic function measures were similarly abnormal.There was a significant difference in RWT and IVS thickness reported higher in HCM group compared to AS and HTN groups. LA volume index (ml/m2) and LA diameter (cm) were enlarged in all groups, LA geometry found worse in HCM followed next by AS group compared to HTN. Additionally, elevated LV filling pressure was higher including (E/e’) and lateral e’ velocity in HCM in comparation to other groups. The prevalence of grade I diastolic dysfunction was the greatest in all the groups without a statistically significant difference of p value. LA reservoir function (LA total emptying) demonstrated a significant difference between the groups with p value of (0.004) it was abnormal in HCM and presented worse in AS group and was depressed linearly with the worsening of diastolic dysfunction grades. No significant difference noted in LA conduit and Pump functions in all the groups. However, it found lower the most in AS group followed next in HCM compared to HTN group. all the groups showed roughly similar normal systolic function by percent of EF with insignificant p value (0.26). however, we found that strain value of LV GLS was depressed nearly the same between all the groups (less than - 18%). Conclusion: Different effects of LV stiffness caused by the hypertrophy of LV presented on LA size and function between the groups. Diastolic dysfunction and high filling pressures were worse in HCM compared to all groups, while LA phasic function tended to be decreased in HCM patients. However, LA phasic function by 2D-STE was worse in the AS patients compared to HTN whopresented borderline LA strain values. Additional finding of our study was that LA reservoir function was depressed linearly with the worsening of diastolic dysfunction in all the groups. These variations can be an indicator of intrinsic LA myocardial dysfunction.74enLALVLVHstrainASdiastolic dysfunctionLeft atrium functionLeft ventricleLA strainLV strainHCMCAThesis