Early Detection of Left Atrial Dysfunction by Speckle Tracking Echocardiography in Hypertensive Patients with Normal Left Atrial Size

Abstract

Background: Arterial hypertension adversely affects LA size and function, effect on function may precede effect on size. This effect is reflected on patient's morbidity and mortality risks. Many techniques were used to assess LA function but with many pitfalls. The objectives: early detection of left atrial dysfunction with speckle tracking echocardiography in hypertensive patients with normal left atrial size. Patients And Methods: The study was conducted on 50 hypertensive patients and 50 age matched normotensive controls , all with normal LA size and free from any other cardiovascular disease that may affect the LA size or function. They were all subjected to history taking, clinical examination and echocardiographic study, both the conventional measures and speckle tracking then both groups were compared regarding LA strain representing LA function. Results: Our study found that hypertensive patients had significantly reduced LA function as measured by speckle tracking when compared to normotensive controls (P-value < 0.001). Also, many factors were associated with worse LA function in hypertensive patients as old age, high BMI, DM, LV diastolic dysfunction, high LV mass index, larger LA size, lower LA expansion index and higher systolic BP. Conclusion: Speckle tracking echocardiography is a useful novel technique in detecting LA dysfunction in hypertension even before LA enlargement occurs.

Left atrial structural and functional remodeling study in type 2 diabetic patients in sub‐Saharan Africa: Role of left atrial strain by 2D speckle tracking echocardiography

“…Concerning the role of PALS in early detection diastolic and LA dysfunction, it is important to highlight that LA strain was markedly reduced in many patients with normal LAVi. In 2016, Bassam et al had similar results in a group of hypertensive subjects in whom LA strain measured by speckle tracking echocardiography allowed early detection of LA dysfunction even before LA dilatation 7 …”

“…They are subjective, depend on the level of expertise of the operator, lack sensibility in detecting early abnormalities, and do not apprehend all the components of myocardial function 6 . Bidimensional speckle tracking echocardiography allows a direct and angle‐independent analysis of myocardial deformation, thus giving sensitive and reproducible myocardial dysfunction indices which overcome the limits of Doppler‐derived measurements 7 . Evaluation of LA deformation mechanics could help in detecting LA dysfunction earlier than the standard measurement methods 8 …”

“…6 Bidimensional speckle tracking echocardiography allows a direct and angle-independent analysis of myocardial deformation, thus giving sensitive and reproducible myocardial dysfunction indices which overcome the limits of Doppler-derived measurements. 7 Evaluation of LA deformation mechanics could help in detecting LA dysfunction earlier than the standard measurement methods. 8 This study aims to evaluate the role of peak atrial longitudinal strain (PALS) through speckle tracking 2D echocardiography for the assessment of structural and functional LA remodeling in a T2DM adult population in Cameroon.…”

Left atrial structural and functional remodelling study in type 2 diabetic patients in sub-saharan Africa: role of left atrial strain by 2D speckle tracking echocardiography.

“…They are subjective, depend on the level of expertise of the operator, lack sensibility in detecting early abnormalities and do not apprehend all the components of myocardial function 6 . Bidimensional speckle tracking echocardiography allow a direct and angle-independent analysis of myocardial deformation, thus giving sensitive and reproductible myocardial dysfunction indices which overcome the limits of Doppler-derived measurements 7 . Evaluation of LA deformation mechanics could help in detecting LA dysfunction earlier than the standard measurement methods 8 .…”