Left Atrial Reservoir Strain by Speckle Tracking Echocardiography: Association With Exercise Capacity in Chronic Kidney Disease

Gan, G.; Bhat, A.; Chen, Henry H.L.; Gu, K.; Kadappu, K.; Eshoo, S.; Thomas, Liza

doi:10.1161/jaha.120.017840

Cited by 16 publications

(10 citation statements)

References 44 publications

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“…Function of LA is important in correlation with symptoms, arrhythmic events, and prognosis. 11) However it is difficult to assess because of its ventricle-dependent dynamic movement as systolic distension, early diastolic contraction, and late diastolic atrial kick. Strain and SR imaging has been proposed as a useful noninvasive echocardiographic technique to quantify regional myocardial function independent of cardiac rotational motion and tethering effect.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Velocity Vector Imaging Can Assess Early Diastolic Dysfunction in Left Ventricular Hypertrophy and Hypertrophic Cardiomyopathy

Yoon

Park

Choi

et al. 2023

J Cardiovasc Imaging

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BACKGROUND The function of left atrium (LA) is difficult to assess because of its ventricle-dependent, dynamic movement. The aim of this study was to assess LA function using velocity vector imaging (VVI) and compare LA function in patients with hypertrophic cardiomyopathy (HCMP) and left ventricular hypertrophy (LVH) with normal controls. METHODS Fourteen patients with HCMP (72% male, mean age of 52.6 ± 9.8), 15 hypertensive patients with LVH (88% male, mean age of 54.0 ± 15.3), and 10 age-matched controls (83% male, mean age of 50.0 ± 4.6) were prospectively studied. Echocardiographic images of the LA were analyzed with VVI, and strain rate (SR) was compared among the 3 groups. RESULTS The e′ velocity (7.7 ± 1.1; 5.1 ± 0.8; 4.5 ± 1.3 cm/sec, p = 0.013), E/e′ (6.8 ± 1.6; 12.4 ± 3.3; 14.7 ± 4.2, p = 0.035), and late diastolic SR at mid LA (−1.65 ± 0.51; −0.97 ± 0.55; −0.82 ± 0.32, p = 0.002) were significantly different among the groups (normal; LVH; HCMP, respectively). The e′ velocity, E/e′, and late diastolic SR at mid LA were significantly different between normal and LVH (p = 0.001; 0.022; 0.018), whereas LA size was similar between normal and LVH (p = 0.592). The mean late diastolic peak SR of mid LA was significantly correlated with indices of diastolic function (E/e′, e′, and LA size). CONCLUSIONS The SR is a useful tool for detailed evaluation of LA function, especially early dysfunction of LA in groups with normal LA size.

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Section: Discussionmentioning

confidence: 99%

Left Atrial Velocity Vector Imaging Can Assess Early Diastolic Dysfunction in Left Ventricular Hypertrophy and Hypertrophic Cardiomyopathy

Yoon

Park

Choi

et al. 2023

J Cardiovasc Imaging

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“…Moreover, E/e’ values > 13 were able to independently predict cardiovascular mortality and MACCE 69 . In addition, impaired LA reservoir strain at rest, even in the absence of DD, was a strong predictor for reduced exercise capacity in 218 patients with CKD stage 3 and 4, with similar efficacy as exercise E/e’ 70 . Thus LA strain could find a place in the rehabilitation of CKD patients, in an attempt to improve their quality of life.…”

Section: Introductionmentioning

confidence: 88%

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

et al. 2021

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Cardiovascular disease and chronic kidney disease are frequently inter‐connected and this association leads to an exponential growth of cardiovascular risk. This risk is currently underestimated by the existing algorithms and there is a constant need for new markers to predict adverse outcomes in this special population. In general population left atrial strain has emerged as an important tool for both the diagnosis and prognostic stratification, but data regarding its role in chronic kidney disease patients is scarce. The purpose of this review is to summarize the current evidence regarding this matter. Left atrial size and function mirror the duration and severity of increased left ventricular filling pressures. Increased left atrial volume index and impaired left atrial strain parameters are independent predictors for adverse cardiovascular events. Left atrial strain is impaired before changes in volume appear, thus being able to predict both diastolic and systolic function in chronic kidney disease patients. Finally, left atrial strain can identify renal patients with impaired exercise capacity and this could have clinical applications in the rehabilitation of this patients.

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“…In the reservoir phase, LA filling with longitudinal stretching corresponds to positive LA strain curve, and its peak before mitral valve opening is measured as LARS (Figure 2 ). 17 , 18 , 19 …”

Section: Methodsmentioning

confidence: 99%

Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility

Hirose,

Nakanishi,

Daimon

et al. 2024

JAHA

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Background Atrial fibrillation (AF) progression is closely related to heart failure occurrence, and catheter ablation carries a beneficial effect for heart failure prevention. Recently, particular attention has been given to left atrial (LA) function and functional reserve in the pathogenesis linking AF and heart failure, although its significance and reversibility is not well studied. Methods and Results We prospectively investigated 164 patients with AF with normal left ventricular systolic function and free from heart failure who underwent first catheter ablation and pre‐/postprocedural echocardiography. Conventional and speckle‐tracking echocardiography were performed at rest and during passive leg lifting to assess LA size, LA reservoir strain (LARS), and functional reserve calculated as passive leg lifting‐LARS – rest‐LARS. Patients were categorized into 3 AF subtypes: paroxysmal AF (N=95), persistent AF (PeAF; N=50), and long‐standing persistent AF (LS‐PeAF; N=19). The PeAF and LS‐PeAF groups had larger LA size and reduced LARS compared with the paroxysmal AF group (all P <0.05). LA functional reserve was significantly impaired in the LS‐PeAF group ( P =0.003). In multivariable analysis, LS‐PeAF and advanced age were significantly associated with impaired LA functional reserve. Among 149 patients with sinus rhythm 1 to 2 days after catheter ablation, LARS was significantly improved in both PeAF and LS‐PeAF groups but was still lower than that in the paroxysmal AF group. Sinus rhythm restoration also led to amelioration of LA functional reserve in patients with LS‐PeAF. Conclusions AF progression was related to impaired LARS and LA functional reserve, and restoration of sinus rhythm might contribute to early LA reverse remodeling.

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Left Atrial Reservoir Strain by Speckle Tracking Echocardiography: Association With Exercise Capacity in Chronic Kidney Disease

Cited by 16 publications

References 44 publications

Left Atrial Velocity Vector Imaging Can Assess Early Diastolic Dysfunction in Left Ventricular Hypertrophy and Hypertrophic Cardiomyopathy

Left Atrial Velocity Vector Imaging Can Assess Early Diastolic Dysfunction in Left Ventricular Hypertrophy and Hypertrophic Cardiomyopathy

Left atrial strain: A novel “biomarker” for chronic kidney disease patients?

Association of Atrial Fibrillation Progression With Left Atrial Functional Reserve and Its Reversibility

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