A systematic review and meta-analysis of left atrial strain in hypertrophic cardiomyopathy and its prognostic utility

Despite advances in noninvasive imaging modalities to identify atrial fibrillation (AF) risk in Hypertrophic Cardiomyopathy (HCM), there is a paucity of evidence concerning the impact of low Left Atrial strain (LAS) on AF and major adverse cardiac events (MACE) incidence in these patients. This study investigated the diagnostic and prognostic significance of LAS in predicting AF and MACE in HCM. Findings revealed lower LA reservoir (MD:-11.79, 95% CI-14.83,-8.74; p<0.00001), booster (MD:-4.10, 95% CI-6.29,-1.91; p=0.0002), and conduit (MD:-7.52, 95% CI-9.39,-5.65; p<0.00001) strains in HCM patients versus healthy controls, and also indicated a significant association between low LA reservoir/conduit/booster strain and the development of new AF as well as MACE prevalence in HCM patients. The results from this study suggest the valuable role of LA strain in HCM and its utility in predicting the development of new AF and cardiac events in HCM patients.