Potential Usefulness and Clinical Relevance of Adding Left Atrial Strain to Left Atrial Volume Index in the Detection of Left Ventricular Diastolic Dysfunction

The purpose of this study was to analyze the potential usefulness and clinical relevance of adding left atrial (LA) strain to left atrial volume index (LAVI) in the detection of left ventricular diastolic dysfunction (LVDD) in patients with preserved left ventricular ejection fraction (LVEF). Recent...

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Bibliographic Details
Published in:JACC. Cardiovascular imaging 2018-10, Vol.11 (10), p.1405-1415
Main Authors: Morris, Daniel A., Belyavskiy, Evgeny, Aravind-Kumar, Radhakrishnan, Kropf, Martin, Frydas, Athanasios, Braunauer, Kerstin, Marquez, Esteban, Krisper, Maximilian, Lindhorst, Ruhdja, Osmanoglou, Engin, Boldt, Leif-Hendrik, Blaschke, Florian, Haverkamp, Wilhelm, Tschöpe, Carsten, Edelmann, Frank, Pieske, Burkert, Pieske-Kraigher, Elisabeth
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atrial Function, Left
Diastole
echocardiography
Echocardiography, Doppler
Female
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Heart Ventricles - diagnostic imaging
Heart Ventricles - physiopathology
Humans
left atrial
Male
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
speckle-tracking
strain
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - etiology
Ventricular Dysfunction, Left - physiopathology
Ventricular Function, Left
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Summary:The purpose of this study was to analyze the potential usefulness and clinical relevance of adding left atrial (LA) strain to left atrial volume index (LAVI) in the detection of left ventricular diastolic dysfunction (LVDD) in patients with preserved left ventricular ejection fraction (LVEF). Recent studies have suggested that LA strain could be of use in the evaluation of LVDD. However, the potential utility and clinical significance of adding LA strain to LAVI in the detection of LVDD remains uncertain. Using 2-dimensional speckle-tracking echocardiography, we analyzed a population of 517 patients in sinus rhythm at risk for LVDD such as those with arterial hypertension, diabetes mellitus, or history of coronary artery disease and preserved LVEF. In patients with LV diastolic alterations and estimated elevated LV filling pressures, the rate of abnormal LA strain was significantly higher than an abnormal LAVI (62.4% vs. 33.6%, p < 0.01). In line with this, in patients with normal LAVI, high rates of LV diastolic alterations and abnormal LA strain were present (rates 80% and 29.4%, respectively). In agreement with these findings, adding LA strain to LAVI in the current evaluation of LVDD increased significantly the rate of detection of LVDD (relative and absolute increase 73.3% and 9.9%; rate of detection of LVDD: from 13.5% to 23.4%; p < 0.01). Regarding the clinical relevance of these findings, an abnormal LA strain (i.e., 
ISSN:1936-878X
1876-7591
DOI:10.1016/j.jcmg.2017.07.029