{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T15:24:03Z","timestamp":1789226643669,"version":"build-2803163510"},"reference-count":46,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Echocardiography"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Septal myectomy relieves left ventricular outflow obstruction (<jats:styled-content style=\"fixed-case\">LVOTO<\/jats:styled-content>) and is associated with excellent long\u2010term outcomes. <jats:styled-content style=\"fixed-case\">LVOTO<\/jats:styled-content> is associated with diastolic dysfunction and increased left atrial (<jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content>) size. We sought to investigate the changes in <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volumes and function postmyectomy and the association between these changes with clinical outcomes postmyectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Sixty\u2010six hypertrophic cardiomyopathy patients undergoing myectomy were retrospectively studied. Preprocedural and 6\u2010 to 18\u2010month postmyectomy follow\u2010up transthoracic echocardiographic images were obtained. <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volumes and strain were assessed by two\u2010dimensional speckle\u2010tracking echocardiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Left atrial volumes, that is, indexed maximal, minimal, and pre\u2010A volumes reduced postmyectomy, yet remained increased compared to controls (105.6\u00a0\u00b1\u00a034.5\u00a0mL vs 84.9\u00a0\u00b1\u00a026.7\u00a0mL, 45.2\u00a0\u00b1\u00a025.7\u00a0mL vs 35.4\u00a0\u00b1\u00a022.6\u00a0mL, 70.1\u00a0\u00b1\u00a031.4\u00a0mL vs 35.4\u00a0\u00b1\u00a022.6\u00a0mL, respectively, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The total emptying index did not improve postmyectomy and remained lower than controls (58.6\u00a0\u00b1\u00a012.4 vs 59.9\u00a0\u00b1\u00a012.8, <jats:italic>P\u00a0<\/jats:italic>=\u00a0<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>) whereas atrial contraction improved, yet did not normalize (active emptying index 36.1\u00a0\u00b1\u00a014.9 vs 41.1\u00a0\u00b1\u00a016.2, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05). The conduit volume remained reduced postmyectomy (18.6\u00a0\u00b1\u00a013.3\u00a0mL vs 16.6\u00a0\u00b1\u00a015.1\u00a0mL, <jats:italic>P\u00a0<\/jats:italic>=\u00a0<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>). <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> strain also did not improve postmyectomy (26.8\u00a0\u00b1\u00a07.3 vs 28.5\u00a0\u00b1\u00a08.8, <jats:italic>P\u00a0<\/jats:italic>=\u00a0<jats:styled-content style=\"fixed-case\">NS<\/jats:styled-content>). A multivariable logistic regression identified preprocedural E\/e\u2032 ratio and indexed maximal <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volume, as independent predictors for <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volume reduction \u226520% postmyectomy. During a mean follow\u2010up of 4.9\u00a0\u00b1\u00a02.3 years postmyectomy, 24.2% of the patients developed atrial fibrillation and &lt;5% of patients were severely symptomatic. We found no associations between <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volumes\/function and atrial fibrillation or symptoms postmyectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Postmyectomy <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volumes decreased, and the contractile function improved. There was no association between <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> volumes\/function and clinical outcomes postmyectomy. Notably, the <jats:styled-content style=\"fixed-case\">LA<\/jats:styled-content> remained enlarged (though to a lesser degree) with reduced strain and emptying fraction, suggesting possible atrial myopathy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/echo.14226","type":"journal-article","created":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T07:44:21Z","timestamp":1549525461000},"page":"276-284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Left atrial remodeling postseptal myectomy for severe obstructive hypertrophic cardiomyopathy: Analysis by two\u2010dimensional speckle\u2010tracking echocardiography"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8472-1021","authenticated-orcid":false,"given":"Adaya","family":"Weissler\u2010Snir","sequence":"first","affiliation":[{"name":"Division of Cardiology Toronto General Hospital University of Toronto  Toronto Ontario 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