Echocardiography in the Assessment of Left Atrial Pressure After Pediatric Heart Surgery

Figueras-Coll, Marc; Sanchez‐de‐Toledo, Joan; Gran, Ferrán; Abella, Raúl; Pérez‐Hoyos, S.; Roses, Ferran

doi:10.1177/2150135115589999

Cited by 8 publications

(5 citation statements)

References 18 publications

(36 reference statements)

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“…Autostrain LA technology is an extension of two-dimensional speckle tracking imaging technology. Unlike previous studies that used left ventricular speckle tracking software to measure and analyze left atrial strain, Autostrain LA achieves time-resolved quantitative dynamic assessment of left atrial myocardial deformation by automatically tracking the motion trajectory of echo speckles that move synchronously with the left atrial myocardium, without being affected by sound beam angle or cardiac preload and afterload [ 24 , 25 ]. Some studies have pointed out that the specialized left atrial strain analysis software significantly improves the intra-observer and inter-observer reproducibility [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Left atrial stiffness index – an early marker of left ventricular diastolic dysfunction in patients with coronary heart disease

Tu,

Liu,

et al. 2024

BMC Cardiovasc Disord

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Aims To evaluate the correlation between left atrial stiffness index (LASI) and left ventricular diastolic function in patients with coronary heart disease (CHD) by Autostrain LA technique. Methods This was a retrospective analysis that included a total of 82 CHD patients who had suitable image quality for left atrial strain measurement. According to the 2016 ASE/EACVI guidelines for the echocardiographic assessment of diastolic dysfunction, the patients were divided into three groups: normal left ventricular diastolic function group (n = 26), indeterminate left ventricular diastolic function (n = 36), and left ventricular diastolic dysfunction (LVDD) (n = 20). The left atrial conduit strain (LAScd), Left atrial contractile strain (LASct), left atrial reservoir strain (LASr) and its derived parameters, including LASI and left atrial filling index (LAFI), were compared among the three groups. Furthermore, we conduct a correlation analysis between LASI and left ventricular diastolic function in patients with CHD. Results LASr and LAScd in normal group were higher than those in indeterminate group, LASr and LAScd in indeterminate group were higher than those in LVDD group, LASI in normal group was lower than that in indeterminate group, and LASI in indeterminate group was lower than that in LVDD group (P < 0.001). LASct in both normal and indeterminate groups was higher than that in LVDD group (P < 0.05). The LAFI of normal group was lower than that of indeterminate group and LVDD group (P < 0.001). LASI was positively correlated with E/e’(r = 0.822) (P < 0.001). LASr and E/e’ were negatively correlated (r = -0.637) (P < 0.001). Conclusion LASI is closely related to the changes of left ventricular diastolic function in CHD patients.

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Section: Discussionmentioning

confidence: 99%

Left atrial stiffness index – an early marker of left ventricular diastolic dysfunction in patients with coronary heart disease

Tu,

Liu,

et al. 2024

BMC Cardiovasc Disord

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“…A non-invasive method has been explored to evaluate left atrial pressure. The combined application of tissue Doppler of atrioventricular valve annulus, pre-mitral flow spectrum and pulmonary vein spectrum can be used for qualitative or semi-quantitative assessment of LAP [ 14 , 15 ], and some can be used for quantitative assessment of LAP [ 16 ], but the correlation with LAP C is only moderate [ 6 , 17 ]. This study focused on the methodology of quantitative and real-time measurement of left atrial pressure using mitral regurgitation spectrum.…”

Section: Discussionmentioning

confidence: 99%

Automatic quantitative measurement of left atrial pressure using mitral regurgitation spectrum: clinical study on comparison with floating catheter

et al. 2022

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Introduction To explore how to measure LAPEq accurately and quantitatively, that is, the left atrial pressure (LAP) measured and calculated by equation method using mitral regurgitation spectrum. Methods The mitral regurgitation spectrum, pulmonary arteriolar wedge pressure (PAWP) and invasive arterial systolic pressure of radial artery of 28 patients were collected simultaneously, including 3 patients with rheumatic heart disease, 15 patients with mitral valve prolapse and 10 patients with coronary artery bypass grafting, patients with moderate or above aortic stenosis were excluded. LAPBp (Doppler sphygmomanometer method), LAPEq (Equation method) and LAPC (Catheter method) were measured synchronously, and the measurement results of the three methods were compared and analyzed. A special intelligent Doppler spectrum analysis software was self-designed to accurately measure LAPEq. This study had been approved by the ethics committee of the Northern Theater General Hospital (K-2019-17), and applied for clinical trial (No. Chictr 190023812). Results It was found that there was no significant statistical difference between the measurement results of LAPC and LAPEq (t = 0.954, P = 0.348), and significant correlation between the two methods [r = 0.908(0.844, 0.964), P < 0.001]. Although the measurement results of LAPC and LAPBP are consistent in the condition of non-severe eccentric mitral regurgitation, there are significant differences in the overall case and weak correlation between the two methods [r = 0.210, (−0.101, 0.510), P = 0.090]. In MVP patients with P1 or P3 prolapse, the peak pressure difference of MR was underestimated due to the serious eccentricity of MR, which affected the accuracy of LAPBP measurement. Conclusions It was shown that there is a good correlation between LAPEq and LAPC, which verifies that the non-invasive and direct quantitative measurement of left atrial pressure based on mitral regurgitation spectrum is feasible and has a good application prospect.

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“…Similarly, left atrial pressure can be measured using surgically inserted left atrial catheters (LAC) [51,52]. Still, alternative less invasive techniques are being used in children to estimate left atrial pressure in unstable patients and LAC or PAC are rarely used in today's intensive care clinical practice [53,54].…”

Section: Pulmonary Artery Pressure (Pap)mentioning

confidence: 99%

Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

et al. 2020

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Background Cardiovascular instability is common in critically ill children. There is a scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children. Methods Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature—a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document. Results Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement,” 20 “weak agreement,” and 2 had “no agreement.” Six statements were considered as redundant after rephrasing of statements following the first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to a lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus. Conclusions These expert consensus-based recommendations may be used to guide clinical practice for hemodynamic monitoring in critically ill children, and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

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Echocardiography in the Assessment of Left Atrial Pressure After Pediatric Heart Surgery

Abstract: While echocardiographic E/e' ratio did not show a good correlation with left atrial pressure in the immediate postoperative period, the positive predictive value may suffice to aid clinicians in predicting elevated pressures.

Cited by 8 publications

References 18 publications

Left atrial stiffness index – an early marker of left ventricular diastolic dysfunction in patients with coronary heart disease

Left atrial stiffness index – an early marker of left ventricular diastolic dysfunction in patients with coronary heart disease

Automatic quantitative measurement of left atrial pressure using mitral regurgitation spectrum: clinical study on comparison with floating catheter

Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

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