Left Atrial Dysfunction Assessed by Two‐Dimensional Speckle Tracking Echocardiography in Patients with Impaired Left Ventricular Ejection Fraction and Sleep‐Disordered Breathing

Miśkowiec, Dawid; Kupczyńska, Karolina; Michalski, Błażej; Uznańska‐Loch, Barbara; Kurpesa, Małgorzata; Lipiec, Piotr

doi:10.1111/echo.12987

Cited by 5 publications

(7 citation statements)

References 32 publications

(64 reference statements)

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“…Speckle tracking echocardiography (STE), developed for the analysis of left ventricular deformation imaging, 3 allows even the evaluation of left atrial function determining the longitudinal deformation of its myocardial fibers. 4 Normal values and feasibility of this methodic have been already defined for the study of left atrium. 5 Recently, peak atrial longitudinal strain (PALS) determined by STE has demonstrated to be more accurate than E/E' to estimate pulmonary wedge pressure in patients with advanced heart failure.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End‐Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

et al. 2015

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Background: This study aimed at exploring the correlation of left atrial longitudinal function by speckle tracking echocardiography (left atrial strain) and Doppler measurements (E/E' ratio) with direct measurements of left ventricular (LV) end-diastolic pressure (LVEDP) in patients stratified for different values of ejection fraction. Methods: The study population was 80 stable patients with sinus rhythm undergoing cardiac catheterization. This population was selected in order to have four groups of 20 patients each with different LV ejection fraction (>55%, 45-54%, 30-44%, and <30%). LVEDP was obtained during cardiac catheterization; peak atrial longitudinal strain (PALS) and mean E/E' ratio were measured in all subjects. Results: Similar correlations with LVEDP of global PALS and E/E' ratio were recorded in patients with preserved (r = À0.79 vs. r = 0.72, respectively; P < 0.0001 for both) or mildly reduced ejection fraction (r = À0.75 vs. r = 0.73, respectively; P < 0.0001 for both). A closer correlation of global PALS compared to E/E' ratio was evident in patients with moderate (r = À0.78 P < 0.0001; vs. r = 0.47 P = 0.01, respectively) and severe reduction (r = À0.74 P < 0.0001; vs. r = 0.19 ns, respectively) of LV ejection fraction. In multivariate analysis of all measurements, global PALS emerged as a determinant of the LVEDP, independent on other confounding factors and, with the cutoff value of 18.0% presented the best diagnostic accuracy to predict a LVDP above 12 mmHg (AUC 0.87). Conclusions: In patients with preserved or mildly reduced LV ejection fraction, global PALS and mean E/E' ratio presented good correlations with LVEDP. In patients with moderate or severe reduction of ejection fraction, E/E' ratio correlated poorly with invasively obtained LV filling pressures. Global PALS provided an overall better estimation of LV filling pressures. (Echocardiography 2016;33:398-405)

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Section: Introductionmentioning

confidence: 99%

“…Speckle tracking echocardiography (STE), developed for the analysis of left ventricular deformation imaging, allows even the evaluation of left atrial function determining the longitudinal deformation of its myocardial fibers . Normal values and feasibility of this methodic have been already defined for the study of left atrium …”

Section: Introductionmentioning

confidence: 99%

Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End‐Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

et al. 2015

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“…Several studies have already proved the usefulness of LA STE in sinus rhythm (12, 18) and in AF (19, 20). LA strain has been shown to have additive value for the risk stratification of embolism and post-stroke mortality (20).…”

Section: Introductionmentioning

confidence: 99%

Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation

Kupczyńska

Michalski²,

Miśkowiec³

et al. 2017

Anatol J Cardiol

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Objective:The aim of the study was to investigate whether the deformation of left atrium (LA) measured by speckle-tracking analysis (STE) is associated with the presence of LA appendage thrombus (LAAT) during non-valvular atrial fibrillation (AF).Methods:Eighty-seven patients (mean age 67 years, 59% men) were included to retrospective cross-sectional study. On top of standard echocardiography we assessed: LA longitudinal systolic strain (LS), systolic (LSSR) and early diastolic strain rate (LESR) in four-chamber and two-chamber apical views. All patients underwent transesophageal echocardiography disclosing LAAT in 36 (41%) patients.Results:Subgroups with and without thrombi did not differ with regard to clinical characteristics. Univariate factors associated with LAAT were as follows: CH2ADS2-VASc Score, left ventricular ejection fraction (LVEF), LV mass, and STE measurements. In a multivariate model only LVEF (p=0.002), LS (p=0.02), LESR (p=0.008), and LSSR (p=0.045) were independently associated with LAAT presence. Moreover, LVEF and LA STE measurements provided incremental value over the CH2ADS2-VASc Score.Conclusion:Speckle-tracking TTE may be used to describe LA reservoir and conduit function during AF, allowing the identification of patients with higher risk of LAAT and providing incremental value over the CH2ADS2-VASc Score.

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“…Classically, elevated LA pressure is attributed to a noncompliant LV, however we now know that there is a certain amount of atrial noncompliance involved. 23 Recent data suggest a higher risk of atrial fibrillation and atrial fibrillation recurrence in those with poorly compliant left atria. 24 Even though the shunt is left to right, the amount of flow getting to the left atrium via the pulmonary veins is increased.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, patient #3's PCWP decreased from 18 to 10 mm Hg and Qp:Qs dropped from 1.9 to 1.4. Classically, elevated LA pressure is attributed to a noncompliant LV, however we now know that there is a certain amount of atrial noncompliance involved . Recent data suggest a higher risk of atrial fibrillation and atrial fibrillation recurrence in those with poorly compliant left atria .…”

Section: Discussionmentioning

confidence: 99%

Fenestrated Transcatheter ASD Closure in Adults with Diastolic Dysfunction and/or Pulmonary Hypertension: Case Series and Review of the Literature

Abdelkarim¹,

Levi²,

Tran³

et al. 2016

Congenital Heart Disease

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Left Atrial Dysfunction Assessed by Two‐Dimensional Speckle Tracking Echocardiography in Patients with Impaired Left Ventricular Ejection Fraction and Sleep‐Disordered Breathing

Abstract: LA dysfunction and remodeling assessed using 2DSTE in patients with impaired systolic LV function, and IHD is influenced by the severity of sleep apnea independently from LV function.

Cited by 5 publications

References 32 publications

Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End‐Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End‐Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction

Association between left atrial function assessed by speckle-tracking echocardiography and the presence of left atrial appendage thrombus in patients with atrial fibrillation

Fenestrated Transcatheter ASD Closure in Adults with Diastolic Dysfunction and/or Pulmonary Hypertension: Case Series and Review of the Literature

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