Abstract 13086: Left Atrial Function in Adult With Normally Functioning Bicuspid Aortic Valves

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Deng Wenhui ◽  
Wang Jing
Keyword(s):  
Blood Pressure ◽  
Left Atrial ◽  
Clinical History ◽  
Stiffness Index ◽  
Lv Function ◽  
Sinus Of Valsalva ◽  
Left Atrial Strain ◽  
History Of ◽  
Atrial Strain ◽  
Left Atrial Dysfunction

Background: Bicuspid aortic valve is a complicated and heterogeneous disease that has aroused great interest in recent years. Traditionally the greatest attention during a routine echocardiography is paid to the function of the ventricles and aortopathy, much less is known about dysfunction the left atrium. The objective of this study was to characterize left atrial strain (LAS) and functions by two-dimensional speckle tracking echocardiography in adult BAV with normally functioning, and interrogate the risk factors. Methods: This is a prospective cohort study of 52 patients (age 40.23±11.29 years) and 33 healthy volunteers (aged 39.12±12.74 years) were recruited. All subjects included in both groups were in sinus rhythm and no clinical history of cardiovascular diseases. We mainly assessed left atrial reservoir, pump, and conduit function using 2D STE, then determined relationships among indices of segmental aortic stiffening, BAV cusp fusion pattern, LV diastolic function indices and LA deformation. Results: Without adjustment, the indices of LA functions in patients with BAV were significantly decreased compared with controls (LAS 49.41 ± 11.14 vs 59.48 ± 9.53, p<0.001, LAEF 71.56 ± 6.57 vs 76.36 ± 5.72, p=0.001; LAS-passive 29.43 ± 9.42 vs 36.67 ± 9.60, p=0.001, LAEF-passive 43.72 ± 10.78 vs 49.58 ± 6.80, p=0.003). However, after adjustment on age, gender, systolic blood pressure, diastolic blood pressure, BSA ,only the LAS was lowering (p<0.001). With or without adjustment, the ascending aorta of patients with BAV were still stiffer at each segment compared with controls. As parameters of LV diastolic functions, the E/e’ ratio (p=0.01) and e’ value (p=0.01) were significantly altered. The LA volume were increased in BAV patients (59.33 ± 19.12 vs 46.10 ± 9.73). In patients with BAV, LA functions, LV functions and segmental aortic stiffness were not influenced by the Sivere valve types. In multiple regression analysis, the stiffness at the sinus of Valsalva were independently correlated with LAS (adjust R 2 = 0.82, β = -0.33, p<0.001). Conclusion: Left atrial dysfunction is common in adult BAV with normally functioning. LA dysfunction is associated with stiffness index at the sinus of Valsalva, and is independent of LV function.

Characteristics of left atrial strain in patients with atrial fibrillatio after cardioversion

2021 ◽  
pp. 20-25
Author(s):  
I. A. Arshinova ◽  
M. G. Poltavskaya ◽  
V. P. Sedov ◽  
A. A. Bogdanova ◽  
A. Y. Suvorov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial ◽  
Myocardial Strain ◽  
Electrical Cardioversion ◽  
Stiffness Index ◽  
Control Group ◽  
Left Atrial Strain ◽  
History Of ◽  
Atrial Strain ◽  
Left Atrial Stiffness

The aim of the study – to evaluate the parameters of left atrial myocardial strain in patients with atrial fibrillation who underwent electrical and drug cardioversion.Materials and methods. The study included 118 patients of the University Clinical Hospital No 1 of the First Sechenov Moscow State Medical University. The analysis was carried out in three groups of patients: group 1 (n=54) – patients with atrial fibrillation who underwent electrical cardioversion; group 2 (n=31) – patients with atrial fibrillation who underwent drug cardioversion; group 3 (n=43) – patients without a history of atrial fibrillation. The clinical and anamnestic data of the medical history of each patient, as well as ultrasound indicators were evaluated: global strain of the left atrial, the values of negative peaks as a reflection of the left atrial systole and the values of positive peaks as a reflection of the filling of the left atrium, LASI – the left atrial stiffness index.Results. The analysis showed that left atrial strain in patients with atrial fibrillation were reduced in all analyzed parameters: negative strain peaks (-9.00 vs. -12.6 in the control group, p<0.001), positive strain peaks (12.6 vs. 14.6 in the control group, p<0.001), global left atrial strain (21.5 in the atrial fibrillation group vs. 27.3 in the control group, p<0.001). Left Atrial Stiffness Index (LASI) was significantly higher in patients with a stopped episode of atrial fibrillation (0.50 vs. 0.40, p=0.006).Conclusions. The indicators of left atrial strain were significantly reduced, and the left atrial stiffness index was significantly increased both in the group with electrical cardioversion and in the group with drug-induced cardioversion, compared with patients with similar cardiovascular pathologies, but without a history of atrial fibrillation episodes.

scholarly journals Left atrial strain predicts cardiovascular response to exercise in young adults with suboptimal blood pressure

2021 ◽  
Author(s):  
Maryam Alsharqi ◽  
Odaro J. Huckstep ◽  
Winok Lapidaire ◽  
Wilby Williamson ◽  
Afifah Mohamed ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Left Atrial ◽  
Cardiovascular Response ◽  
Left Atrial Strain ◽  
Atrial Strain ◽  
Response To Exercise

P1481B-lines and left atrial strain in outpatients with suspected heart failure with preserved ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Agoston ◽  
L Gargani ◽  
I Szabo ◽  
B Illes ◽  
A Varga
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Lung Ultrasound ◽  
Preserved Ejection Fraction ◽  
Pulmonary Congestion ◽  
Left Atrial Strain ◽  
Atrial Strain ◽  
Left Atrial Dysfunction ◽  
B Lines

Abstract Background Heart Failure with Preserved Ejection Fraction (HFpEF) is a growing healthcare burden and its prevalence is increasing. Diagnosing HFpEF is challenging. Lung ultrasound (LUS) and left atrial strain are promising tools to assess pulmonary congestion and left atrial dysfunction in outpatient settings in patients with suspected HFpEF. Aim To evaluate the correlation of LUS B-lines with left atrial strain in patients with HFpEF. Methods Thirty-six consecutive patients (24 women, mean age 70±6 years) with clinical signs of heart failure were prospectively enrolled. Exclusion criteria were: ejection fraction <55%, more than mild mitral and/or aortic valve disease, pulmonary disease, pulmonary arterial hypertension. Within one hour all patients underwent comprehensive echocardiographic evaluation including left atrial strain analysis (peak atrial longitudinal strain-PALS), lung ultrasound assessment of B-lines on the antero-lateral and posterior chest wall, and NT-proBNP levels. Results The mean ejection fraction was 65.5±8.6%. In 28 patients (85%) a significant number of B-lines (≥15) was observed. We found a positive correlation between the number of B-lines and NT-proBNP levels (p<0.0001, r: 0.76, Figure 1.), left atrial volume (p<0.05, r: 0.45), and PALS (p<0.05, r: −0.5, Figure 2.). We didn't found any correlation between the number of B-lines and E/e'ratio (p=0.1, r: 0.28), or between E/e' ratio and NT-proBNP level (p=0.2, r: 0.2). Conclusion LUS is a simple, feasible tool to detect pulmonary congestion in HFpEF and it seems to better characterize these patients. B-lines correlate well with NT-proBNP values and with parameters of left atrial dysfunction. PALS is a promising too which better reflects pulmonary congestion and elevated NT-proBNP values than the conventional echocardiographic parameter E/e'.

P4372Left atrial strain: a potential marker of early diastolic dysfunction in patients with Marfan syndrome

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Garcia-Izquierdo Jaen ◽  
S Mingo Santos ◽  
M Torres Sanabria ◽  
V Monivas Palomero ◽  
S Moreno Casado ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ejection Fraction ◽  
Strain Rate ◽  
Diastolic Dysfunction ◽  
Left Atrial ◽  
Left Ventricular ◽  
Healthy Controls ◽  
Left Atrial Strain ◽  
Strain And Strain Rate ◽  
Atrial Strain

Abstract Background/Introduction Previous studies using conventional echocardiographic measurements have reported subclinical left diastolic dysfunction in patients with Marfan syndrome (MFS). Left atrial strain (LAS) has been shown to be an accurate predictor of left ventricular diastolic dysfunction. However, there is no evidence regarding the use of LAS in MFS. Purpose To assess feasibility of LAS and compare LAS derived measurements along with traditional diastolic parameters in MFS patients vs healthy controls. Methods 46 MFS patients (normal LV ejection fraction, no previous cardiovascular surgery, no significant valvular regurgitation) vs. 20 healthy controls (age and sex-matched). We performed LAS analysis using 2D speckle-tracking (QLAB 10, Philips). LA strain was determined as the average value of the longitudinal deformation (7 segments) in the apical 4-chamber view (RR gating). Results LAS analysis was feasible in 40 MFS patients (87%). All participants had normal diastolic function according to current guidelines (ASE/EACVI 2016). MFS patients showed lower TDI e' velocities and higher average E/e' ratio, but still within normal range. Similarly, LVEF was normal but slightly reduced in MFS patients. LA strain and strain rate parameters during reservoir and conduit phase were significantly impaired in MFS patients compared to controls. MFS vs controls MFS patients (n=40) Controls (n=20) p MFS patients (n=40) Controls (n=20) p Age 33.8±12.4 34.4±8.3 0.846 Septal e' (cm/s) 9.7±2.5 11.7±2.3 0.006 Male (%) 24 (60%) 12 (60%) 1.000 Average E/e' ratio 6.8±1.5 5.5±1.1 0.002 SBP (mmHg) 120.3±12.4 120.1±9.4 0.969 TR velocity (cm/s) 208.6±21.4 201.6±22.9 0.390 DBP (mmHg) 72.0±10.1 67.1±6.2 0.069 LAVi (ml/m2) 23.5±7.1 25.5±4.8 0.260 Aortic root (mm) 40.3±4.6 31.7±3.7 <0.001 LASr (%) 32.6±8.8 43.0±8.3 <0.001 LVEF (%) 60.9±5.6 64.2±4.2 0.022 LAScd (%) −20.1±8.0 −29.4±5.5 <0.001 E-wave (cm/s) 74.6±16.5 76.7±16.5 0.651 LASct (%) −12.8±6.1 −13.6±5.2 0.622 A-wave (cm/s) 55.2±10.9 52.0±12.8 0.327 LASRr 2.02±0.49 2.31±0.43 0.030 E/A ratio 1.4±0.4 1.5±0.4 0.287 LASRcd −2.22±0.61 −3.07±0.68 <0.001 Lateral e' (cm/s) 13.0±3.6 16.3±3.3 0.002 LASRct −2.24±0.90 −2.35±0.75 0.600 SBP: Systolic blood pressure. DBP: Diastolic blood pressure. LVEF: Left ventricular ejection fraction. LAVi: Left atrial volume index. LAS: Left atrial strain. LASR: Left atrial strain rate. (r): Reservoir. (cd): Conduit. (ct): Contraction. Example of LA strain and strain rate Conclusion MFS patients showed a subtle impairment in diastolic function compared to controls. Although further evidence is needed, LAS derived parameters could be early markers of diastolic dysfunction in this group of patients. Acknowledgement/Funding Programa de Actividades de I+D de la Comunidad de Madrid

scholarly journals P1586 Lung ultrasound and left atrial deformation analysis: a promising methods for the diagnosis of heart failure with preserved ejection fraction

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
G Agoston ◽  
L Gargani ◽  
I Szabo ◽  
B Illes ◽  
A Varga
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Lung Ultrasound ◽  
Preserved Ejection Fraction ◽  
Pulmonary Congestion ◽  
Left Atrial Strain ◽  
Atrial Strain ◽  
Left Atrial Dysfunction ◽  
B Lines

Abstract Background Heart Failure with Preserved Ejection Fraction (HFpEF) is a growing healthcare burden and its prevalence is increasing. Diagnosing HFpEF is challenging. Lung ultrasound (LUS) and left atrial strain are promising screening tools to assess pulmonary congestion and left atrial dysfunction in patients with suspected HFpEF. Aim To evaluate the relationship between LUS, left atrial strain and NT-proBNP level in patients with HFpEF. Also to assess the diagnostic power of B-lines in HFpEF population. Methods Forty-seven consecutive patients (24 women, mean age 69 ± 11 years) with clinical signs of heart failure were prospectively enrolled. Exclusion criteria were: ejection fraction &lt;55%, more than mild mitral and/or aortic valve disease, pulmonary disease, pulmonary arterial hypertension. Within one hour all patients underwent comprehensive echocardiographic evaluation including left atrial strain analysis (peak atrial longitudinal strain-PALS), lung ultrasound assessment of B-lines on the antero-lateral and posterior chest wall, and NT-proBNP levels. Results In 34 patients (72%) a significant number of B-lines (≥15) were observed. We found a positive correlation between the number of B-lines and NT-proBNP levels (p &lt; 0,0001, r = 0,74, Figure 1.), left atrial volume (p &lt; 0,05, r = 0,45), and PALS (p &lt; 0,02, r = 0,4 ). We didn’t found any correlation between the number of B-lines and E/e’ ratio (p = 0,1, r = 0,28), or between E/e’ ratio and NT-proBNP level (p = 0,1, r = 0,2). We also assessed the diagnostic ability of ≥15 B-lines to predict markedly elevated pro-BNP level (≥ 220pg/ml), AUC was 0.89. If the total number of B-lines was greater or equal to 28, the sensitivity was 68% with the specificity of 100%, but if we changed the cut-off value to 12, the sensitivity grew to 89% with the specificity of 71%. (Figure 2.). Conclusion LUS is a simple, feasible tool to detect pulmonary congestion in HFpEF and it has a strong diagnostic power to predict elevated NTpro-BNP level. B-lines correlate with parameters of left atrial dysfunction. PALS is promising too, which better reflects pulmonary congestion and elevated NT-proBNP values than the conventional echocardiographic parameter E/e’. Abstract P1586 Figure. NT-pBNP vs B-lines, AUC of Blines

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