Heart Failure With Preserved Ejection Fraction

Jellis, Christine; Klein, Allan L.

doi:10.1161/circimaging.116.004521

Cited by 7 publications

(5 citation statements)

References 20 publications

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“…It has been proposed that peak LA strain provides incremental insight beyond typical measures of remodeling, namely LA enlargement, a finding which in itself accompanies a number of cardiovascular diseases [9, 14]. Indeed, our results support this notion, as LAVi > 34 mL/m 2 was able to identify subjects with elevated LV filling pressures, but at the cost of a higher false positive rate compared to peak LA strain (Fig.…”

Section: Discussionsupporting

confidence: 76%

“…There is a growing body of data supporting the clinical application of LA reservoir strain as a diagnostic and prognostic marker across a spectrum of cardiovascular disease, including atrial fibrillation, heart failure with preserved EF, mitral valve disorders, and categorization of diastolic dysfunction [4, 9–13]. It has been proposed that peak LA strain provides incremental insight beyond typical measures of remodeling, namely LA enlargement, a finding which in itself accompanies a number of cardiovascular diseases [9, 14]. Indeed, our results support this notion, as LAVi > 34 mL/m 2 was able to identify subjects with elevated LV filling pressures, but at the cost of a higher false positive rate compared to peak LA strain (Fig.…”

Section: Discussionmentioning

confidence: 99%

“…However, the converse of this finding was evident in the improved performance of LA reservoir strain in the cohort with preserved LV EF. Although elevated filling pressures in the setting of normal LV function may be less frequently suspected, accurate diagnosis of this condition is of increasing importance given the growing epidemic of heart failure with preserved EF, in which patients are symptomatic and LA dysfunction has been implicated as a major contributor to symptomatology [9, 18]. Furthermore, the previously demonstrated relationship between progressive diastolic dysfunction and worsening LA strain demonstrated by our group suggests that with preserved EF, the associated alterations in LA strain may provide timely reflections of dynamic changes in filling pressures and concomitant cardiac mechanics [4].…”

Section: Discussionmentioning

confidence: 99%

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Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures

Singh

Medvedofsky

Mediratta

et al. 2018

Int J Cardiovasc Imaging

126

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Echocardiographic assessment of left ventricular (LV) filling pressures is performed using a multi-parametric algorithm. Left atrial (LA) strain was recently found to accurately classify the degree of diastolic dysfunction. We hypothesized that LA strain could be used as a stand-alone marker and sought to identify and test a cutoff, which would accurately detect elevated LV pressures. We studied 76 patients with a spectrum of LV function who underwent same-day echocardiogram and invasive left-heart catheterization. Speckle tracking was used to measure peak LA strain. The protocol involved a retrospective derivation group (N = 26) and an independent prospective validation cohort (N = 50) to derive and then test a peak LA strain cutoff which would identify pre-A-wave LV diastolic pressure > 15 mmHg. The guidelines-based assessment of filling pressures and peak LA strain were compared side-by-side against invasive hemodynamic data. In the derivation cohort, receiver-operating characteristic analysis showed area under curve of 0.76 and a peak LA strain cutoff < 20% was identified as optimal to detect elevated filling pressure. In the validation cohort, peak LA strain demonstrated better agreement with the invasive reference (81%) than the guidelines algorithm (72%). The improvement in classification using LA strain compared to the guidelines was more pronounced in subjects with normal LV function (91% versus 81%). In summary, the use of a peak LA strain to estimate elevated LV filling pressures is more accurate than the current guidelines. Incorporation of LA strain into the non-invasive assessment of LV diastolic function may improve the detection of elevated filling pressures.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures

Singh

Medvedofsky

Mediratta

et al. 2018

Int J Cardiovasc Imaging

126

View full text Add to dashboard Cite

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“…STE-derived parameters such as strain and strain rate are less load-dependent than the conventional echocardiographic markers [5] and STE-derived LA strain currently constitutes the best method to assess atrial function [9]. To date, atrial strain has been evaluated in multiple conditions, especially HF and atrial fibrillation [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of left atrial myocardial function and compliance in patients with pre-eclampsia

Sun

Wang

et al. 2020

Preprint

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Background: Pre-eclampsia (PE) is a severe obstetric complication associated with many cardiovascular disorders. Left atrial (LA) function and its relevance to the cardiovascular adaptation changes associated with PE have not been adequately addressed. The aim of this study was to quantify LA myocardial deformation characteristics in women with PE using speckle tracking echocardiography (STE). Methods: Using STE, LA global longitudinal strain (LAGLS), phasic LA strain values and LASr/(E/e'), which was the value of LA reservoir strain (LASr) divided by the quotient of early mitral flow velocity (E) and diastolic mitral ring velocity (e'), were compared among nonpregnant controls (n=39), normotensive pregnant women (n=40), and PE (n=43) patients. Results: LAGLS, LASr and LA conduit strain reduced in PE group in spite of no difference of LA contraction strain among the three groups. LASr/(E/e'), the surrogate of LA compliance, was decreased during PE pregnancy. The multivariate regression analyses showed LAGLS was independently correlated with LASr/(E/e'), left ventricular global longitudinal strain and LA maximum volume. Conclusion: PE cases undergo impaired LA myocardial function and decreased atrial compliance. STE-derived LA strain may be a powerful diagnostic parameter to evaluate diastolic function with the progression of PE pregnancy.

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“…fibrilação atrial 64,[110][111][112][113] , estenose aórtica 114,115 , amiloidose 116 , síndrome coronária aguda 65,86,117 , pericardite constrictiva 118 e IC com fração de ejeção preservada [119][120][121][122] 10 REFERÊNCIAS…”

Section: Variáveis Ecocardiográficasunclassified

Avaliação ecocardiográfica da função do átrio esquerdo como marcadora de eventos em pacientes com insuficiência cardíaca

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Heart Failure With Preserved Ejection Fraction

Cited by 7 publications

References 20 publications

Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures

Peak left atrial strain as a single measure for the non-invasive assessment of left ventricular filling pressures

Quantitative analysis of left atrial myocardial function and compliance in patients with pre-eclampsia

Avaliação ecocardiográfica da função do átrio esquerdo como marcadora de eventos em pacientes com insuficiência cardíaca

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