Left Atrial Intrinsic Strain Rate Correcting for Pulmonary Wedge Pressure Is Accurate in Estimating Pulmonary Vascular Resistance in Breathless Patients

Tossavainen, Erik; Henein, Michael Y.; Grönlund, Christer; Lindqvist, Per

doi:10.1111/echo.13226

Cited by 17 publications

(23 citation statements)

References 35 publications

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“…Comparing LA diameter, LAVI and LA deformation measures in ATTR amyloidosis patients with or without atrial arrhythmias on Holter ECG, LASRa was the only parameter that was in difference between the 2 groups (p ¼ .006). The reproducibility of LASRa measurements has previously been shown by the authors to be quite satisfactory [15].…”

Section: Predictors Of Atrial Arrhythmiamentioning

confidence: 78%

Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis

Henein

Suhr

Arvidsson

et al. 2018

Amyloid

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Section: Predictors Of Atrial Arrhythmiamentioning

confidence: 78%

Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis

Henein

Suhr

Arvidsson

et al. 2018

Amyloid

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“…This might indicate that LASRa is a relatively sensitive marker for PCWP, which is known to be difficult to assess. The use of LASRa, but not LA conduit (LASRe) or reservoir (LASRs) strain rate, as reliable marker for PCWP supports our own previous findings (Tossavainen et al ., ). In contrast, the commonly used markers of raised LA pressure, that is, E/A and E/e’ were significantly less accurate in predicting PCWP.…”

Section: Discussionmentioning

confidence: 97%

“…LASRa, on the other hand, represents cavity deformation during LA contraction, therefore by definition is more directly related to intracavitary pressure changes. We have previously shown that LASRa correlate with PCWP at rest (Tossavainen et al ., ), being the LA strain measure least influenced by LV function (Ramkumar et al ., ). Furthermore, we have shown that LASRa can accurately predict atrial arrhythmia (Henein et al ., ,).…”

Section: Discussionmentioning

confidence: 99%

Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?

Henein

Tossavainen

Aroch

et al. 2018

Clin Physio Funct Imaging

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Summary Aims Non‐invasive estimation of left ventricular filling pressure (LVFP) during stress is important for explaining exertional symptoms in patients with heart failure (HF). The aim of this study was to evaluate ability of Doppler echocardiographic measures of elevated LVFP with passive leg lifting (PLL) in patients with suspected HF. Methods Twenty‐nine patients with clinical signs of HF who underwent simultaneous Doppler echocardiography and right heart catheterization (RHC) at rest and during PLL were consecutively investigated. Seventeen patients had normal PCWP (≤15 mmHg) at rest and during PLL and 12 with normal PCWP at rest but >15 mmHg with PLL. Conventional echo and 2D strain were used to assess early diastolic blood flow velocity (E), LV strain rate during early diastole (LVSRe), left atrial SR during atrial contraction (LASRa) and myocardial tissue Doppler velocities to assess lateral e’ and further calculate E/e’ and E/LVSRe and their relationship with PCWP, at rest and during PLL. Results Resting LAVI (β = 0·45, P = 0·009) and LASRa (β = −0·51, P = 0·004) were independently related to PCWP during PLL. Also, LASRa (β = −0·77, P<0·001), E/e’ (β = 0·40, P = 0·04) and E/LVSRe (β = 0·47, P = 0·021) during PLL correlated with PCWP during PLL. Multiple regression analysis identified E/LVSRe (β = 0·46, P = 0·001) and LASRa (β = −0·58, P = 0·002) during PLL as being independently associated with PCWP during PLL. Conclusion Left atrial volume and myocardial contraction (LASRa) at rest both predict unstable LV filling pressures measured as raised PCWP when provoked by PLL. Furthermore, LASRa at PLL seems to have the strongest association to PCWP during PLL.

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“…The same group has shown that LA strain may be a superior marker that could not only discriminate all grades of LV diastolic dysfunction vs. normal with excellent areas under the curves but also demonstrate that LA strain is useful for “accurate characterization” of LV diastolic dysfunction . Tossavainen et al showed that in patients with HF, LA strain rate during atrial contraction correlated strongly with pulmonary capillary wedge pressure and the correlation was better than the E/e’ ratio . Brand et al have shown that LV diastolic dysfunction is associated with decreased RA and RV free wall strain.…”

Section: Could Biatrial and Rv Strain Aid In The Diagnosis Of LV Diasmentioning

confidence: 99%

“…Although there is a reportedly plausible association between LA strain and LV filling pressure, such association in the right‐sided heart and the pulmonary artery circuit is less well established. We present here a short report on a possible mechanistic and hemodynamic association between RA strain and right heart catheterization obtained PASP, pulmonary vascular resistance, and RA pressure.…”

Section: Pulmonary Heart Disease and Right Atrial Mechanicsmentioning

confidence: 99%

Biatrial and right ventricular deformation imaging: Implications of the recent EACVI consensus document in the clinics and beyond

et al. 2019

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In this review, right ventricular (RV), right atrial (RA), and left atrial (LA) strain in some selected clinical situations has been discussed in light of the current literature. To exemplify the significance of the use of multichamber strain, we have provided some illustrations of common cardiac problems. The recently published European Association of Cardiovascular Imaging (EACVI) consensus document for standardization of RV, RA, and LA strain, using the currently available software, has fulfilled the aspirations of investigators world over who have been studying atrial strain using a bailed‐out algorithm designed principally to quantify left ventricular deformation. The purpose of this review was to reiterate the value of the application of RV and biatrial strain imaging in research and day‐to‐day clinical practice, using the 2‐dimensional speckle tracking echocardiography (2D‐STE). Also, we present a short report on how RA strain may remain coupled to pulmonary hemodynamics. Besides, we have highlighted the technical challenges of atrial strain quantification. We have not used the nomenclature of chamber deformation proposed by the EACVI document as the publications cited in this review have used different sets of nomenclature.

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Left Atrial Intrinsic Strain Rate Correcting for Pulmonary Wedge Pressure Is Accurate in Estimating Pulmonary Vascular Resistance in Breathless Patients

Abstract: Left atrial strain rate during atrial systole correlates closely with pulmonary capillary wedge pressure and consequently the calculated pulmonary vascular resistance, irrespective of the etiology of PH.

Cited by 17 publications

References 35 publications

Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis

Reduced left atrial myocardial deformation irrespective of cavity size: a potential cause for atrial arrhythmia in hereditary transthyretin amyloidosis

Can Doppler echocardiography estimate raised pulmonary capillary wedge pressure provoked by passive leg lifting in suspected heart failure?

Biatrial and right ventricular deformation imaging: Implications of the recent EACVI consensus document in the clinics and beyond

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