scholarly journals Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure

2020 ◽  
Vol 7 (4) ◽  
pp. 1956-1965 ◽  
Author(s):  
Athanasios Frydas ◽  
Daniel A. Morris ◽  
Evgeny Belyavskiy ◽  
Aravind‐Kumar Radhakrishnan ◽  
Martin Kropf ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Left Atrial Strain ◽  
Ventricular Diastolic Dysfunction ◽  
Atrial Strain ◽  
Sensitive Marker

P1482Preclinical diastolic dysfunction assessed by left atrial strain and association with incident heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Potter ◽  
S Ramkumar ◽  
H Yang ◽  
H Kawakami ◽  
K Negishi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular ◽  
Community Dwelling ◽  
Volume Index ◽  
P Value ◽  
Left Atrial Strain ◽  
Atrial Strain

Abstract Background Left atrial strain in the reservoir phase (LASr) measures passive LA stretch and is a sensitive marker of left ventricular diastolic dysfunction (DD). However, reduced LASr has not been prospectively validated against clinical heart failure (HF) endpoints and its place in diastology evaluation is unclear. Aim We sought whether DD grades defined by previously validated ranges of LASr predicted incident HF and whether reclassifying indeterminate diastolic function based on reduced LASr could facilitate assessment of HF risk. Methods Community dwelling elderly subjects were recruited and underwent baseline clinical and echocardiographic assessment. Where imaging was suitable, speckle-tracking echocardiography assessed LASr and subjects were assigned DD grades based on published ranges: normal >35%, grade 1 24–35%, grade 2 19–24%, grade 3 <19%. Current ASE/EACVI recommendations were used to identify those with indeterminate function; LASr-defined DD (LASr-DD) was defined as LASr ≤23%. Follow-up was ≤2 years and incident HF adjudicated by Framingham criteria. Results Of 610 subjects (age 71±5 yrs., 46% male) LASr analysis was feasible in 590 (97%); average LASr was 39% (IQR 34–43%). Incident HF was associated with LASr-DD grade, occurring in 8 (36%) with grade ≥2, 14 (10%) with grade 1 and 39 (9%) with normal function (p<0.001). Adjusted odds ratio for incident HF for LASr-DD grade ≥2 was 3.12 (95% CI 1.06–9.1, p=0.038) Diastolic function was indeterminate in 147 (24%) subjects; of 144 (98%) with LAS analysis, 6 (75%) of those with LASr-DD vs. 15 (11%) with normal LASr experienced incident HF (p<0.001). Univariable Multivariable* OR (95% CI) p-value OR (95% CI) p-value LASr-DD grade:   1 1.13 (0.59–2.15) 0.7 0.84 (0.42–1.69) 0.63   ≥2 5.7 (2.26–14.5) <0.001 3.12 (1.06–9.1) 0.038 *Adjusted for age, hypertension, diabetes, BMI, global longitudinal strain, E/e', LA volume index, LV mass index (all p<0.1 on univariable analysis). Incorporating LA strain in practice Conclusion DD defined by LASr is predictive of HF for grades ≥2 independent of other diastolic measures. Indeterminate diastolic function with LASr ≤23% is associated with incident HF. LASr may complement current diastolic function assessment recommendations. Acknowledgement/Funding Baker Heart and Diabetes Institute

scholarly journals The Role of Left Atrial Strain in Detecting Left Ventricular Diastolic Dysfunction: Comparison between the 2009 and 2016 Recommendations

2021 ◽  
Author(s):  
Niloufar Samiei ◽  
Fatemeh Abbasi ◽  
Maryam Shojaeifard ◽  
Mozhgan Parsaee ◽  
Saeid Hosseini ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Volume Index ◽  
Current Guideline ◽  
Left Atrial Strain ◽  
Ventricular Diastolic Dysfunction

Background: The frequency of left ventricular diastolic dysfunction (DD) is overestimated by earlier recommendations. We compared the 2009 and 2016 guidelines regarding the detection of DD and explored the potential of adding left atrial (LA) strain to the current guideline. Methods: Consecutive patients with heart failure were enrolled. All the patients were examined using 2-dimensional speckle-tracking echocardiography (2D-STE) and tissue Doppler imaging. DD was evaluated in terms of E/eʹ, eʹ velocity, E, A, tricuspid regurgitation velocity, LA volume, and LA strain. Results: This study evaluated 147 patients (101 males, 68.7%) at a mean age of 54.73±14.42 years. LA strain decreased with increasing grades of DD in both guidelines. The rate of reclassification between the 2 guidelines was 41%. The detection rate of normal diastolic function increased after the implementation of the 2016 guideline. LA strain discriminated individuals with normal diastolic function from those with DD more accurately than did LA volume index (area under the curve [AUC] =0.816 vs AUC=0.759, respectively). When LA strain <23% was incorporated into the 2016 guideline, 2 out of 4 patients with indeterminate diastolic function were reclassified as normal and 2 patients as grade I DD. The rate of reclassification was 4.1% after the addition of LA strain to the current guideline (κ=0.939, P<0.001). Conclusion: This study showed that the current guideline detected lower rates of DD than did the earlier recommendations. Furthermore, the incorporation of LA strain into the current guideline resulted in lower rates of indeterminate diastolic function.

Estimation of Left Ventricular Wall Stiffness by Analysis of Late Diastolic Pressure Components

2011 ◽  
Author(s):  
Casandra L. Niebel ◽  
Kelley C. Stewart ◽  
Takahiro Ohara ◽  
John J. Charonko ◽  
Pavlos P. Vlachos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricle ◽  
Diastolic Dysfunction ◽  
Diastolic Pressure ◽  
Left Ventricular Diastolic Dysfunction ◽  
Left Ventricular ◽  
Ventricular Wall ◽  
Ventricular Relaxation ◽  
Wall Stiffness ◽  
Ventricular Diastolic Dysfunction

Left ventricular diastolic dysfunction (LVDD) is any abnormality in the filling of the left ventricle and is conventionally evaluated by analysis of the relaxation driven phase, or early diastole. LVDD has been shown to be a precursor to heart failure and the diagnosis and treatment for diastolic failure is less understood than for systolic failure. Diastole consists of two filling waves, early and late and is primarily dependent on ventricular relaxation and wall stiffness.

Sign in / Sign up

Export Citation Format

Share Document