INTRODUCTION
Several studies have suggested that left ventricular hypertrophy (LVH)
is associated with a higher prevalence of comorbidities and adverse
cardiovascular outcomes in subjects with previous cardiovascular events
(1–4). Moreover, ventricular remodeling causes atrial distortion such
as left atrial (LA) enlargement, which is a significant predictor of
adverse cardiovascular events (5). Evidence suggests that LVH could be
the mechanism that produces left ventricular dysfunction rather than a
compensatory mechanism to maintain left ventricular wall stress and
forward output (6). This condition was evaluated in subjects with mild
to moderate aortic stenosis, where LVH occurred in 17%; in asymptomatic
severe aortic stenosis and in subjects with arterial hypertension LVH
was found in up to 67% of the cases (7). This has led to the hypothesis
that ventricular remodeling could be evaluated using other global
myocardial parameters such as global strain, especially to determine
myocardial dysfunction. Left atrial volume and function are sensitive
indicators of left ventricular (LV) filling pressure and diastolic
dysfunction. Evaluation of left atrial and left ventricular
global-strain (LA-GS; LV-GS) using 2-D speckle tracking analysis has
been shown to be an accurate automatized diagnostic tool for functional
evaluation of different cardiomyopathies (8). Furthermore, decrease of
LA-GS has been associated with increased incidence of atrial
fibrillation, sudden cardiac arrest and increased mortality (9-11). Both
ventricular geometry and strain evaluation by speckle tracking have been
proposed as complementary tools. The aim of this study was to compare
LV-GS and LA-GS values, assessed by 2D-velocity vector imaging in
different geometric remodeling variants in adult patients. Additionally,
the associated risk factors for ventricular and atrial dysfunction, as
defined using LV-GS and LA-GS were assessed. We hypothesize that global
strain is correlated with ventricular function and could be impaired
with different ventricular geometric variants. Thus, a specific
ventricular variant could be associated with ventricular and atrial
dysfunction.