Left atrial reservoir strain combined with E/E' as a better single measure to predict elevated LV filling pressures in patients with coronary artery disease

Lin, Jianzhong; Ma, Hong; Gao, Lijian; Wang, Yang; Wang, Jiangtao; Zhu, Zhenhui; Pang, Kunjing; Wang, Hao; Wu, Wenzhi

doi:10.1186/s12947-020-00192-4

Cited by 34 publications

(30 citation statements)

References 45 publications

(48 reference statements)

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“…LAS by STE shows a promising, non-invasive approach to predicting changes in LV filling pressure. Recent studies show that LAS at reservoir phase predicts elevated LV end-diastolic pressure in patients with coronary artery disease [ 79 ] and patients with normal LVEF [ 45 ]. Another study that included 76 patients referred for left heart catheterization demonstrated LA reservoir strain to be an independent predictor of LV filling pressure, with a cutoff value of LASr < 20% being optimal to detect elevated LV filling pressure (area under the curve 0.76) [ 47 ].…”

Section: Prognostic Value Of La Deformationmentioning

confidence: 99%

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

Alfuhied

Kanagala

McCann

et al. 2021

Int J Cardiovasc Imaging

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The left atrium (LA) plays a vital role in maintaining normal cardiac function. LA volume and function have been utilised as important imaging biomarkers, with their prognostic value demonstrated in multiple cardiac conditions. More recently, there has been a sharp increase in the number of publications utilising LA strain by echocardiography and cardiac magnetic resonance (CMR) imaging. However, little is known about its prognostic value or reproducibility as a technique. In this review, we aim to highlight the conventional and novel imaging techniques available for LA assessment, using echocardiography and CMR, their role as an imaging biomarker in cardiovascular disease, the reproducibility of the techniques and the current limitations to their clinical application. We identify a need for further standardisation of techniques, with establishment of ‘normal’ cut-offs before routine clinical application can be made.

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Section: Prognostic Value Of La Deformationmentioning

confidence: 99%

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

Alfuhied

Kanagala

McCann

et al. 2021

Int J Cardiovasc Imaging

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“…LA reservoir function represents LA filling by pulmonary vein flow during ventricular systole and demonstrates stiffness of the left atrium, producing higher pressures. For example, LA reservoir strain has previously been correlated with left ventricular filling parameters and negatively correlated with mean pulmonary artery pressure and pulmonary capillary wedge pressure [20,21]. Owing to the pathophysiological link between left-side heart diseases and the development of functional TR, the finding that recurrent TR could be predicted by parameters correlating with LA function can be explained.…”

Section: Discussionmentioning

confidence: 99%

The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study

Meng

Jia

et al. 2021

Cardiovasc Ultrasound

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Background Functional tricuspid regurgitation (TR) is common among patients with left heart disease and may recur during the follow-up period after selective tricuspid valve annuloplasty (TVA). This study aims to analyse the relationship between left atrial (LA) strain and the degree of preoperative functional TR and to explore the role of LA strain in predicting TR recurrence. Methods This study included 63 patients with rheumatic mitral stenosis who underwent mitral valve replacement and concomitant TVA. Additionally, 20 healthy controls were enrolled. Preoperative conventional LA echocardiographic parameters and LA strain were measured. The association between LA strain and preoperative functional TR severity was analysed by Pearson correlation. Predictors of recurrent TR were determined by multivariate logistic regression analyses. Results Compared with the control group, the mitral stenosis group developed a significant impairment in terms of LA strain. The degree of preoperative functional TR exhibited moderate correlations with LA reservoir strain (r = − 0.57) and LA conduit strain (r = 0.48). During a median follow-up period of 66.4 ± 36.4 months, TR recurred in 18 patients. Preoperative LA reservoir strain and the mean transmitral gradient were predictors of postoperative TR recurrence. When the two indexes were combined to establish a prediction, the sensitivity and specificity of prediction increased. The area under the receiver operating characteristic curve of the combined indicator was higher than those of the single indicators (0.90 vs. 0.70 and 0.72). Conclusions LA strain correlates with preoperative functional TR severity in patients with rheumatic mitral stenosis. The LA reservoir strain and preoperative mean transmitral gradient are independent predictive factors for recurrent TR after TVA.

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“…LASI [38,39] or LA compliance (the reciprocal of LASI) [7] is useful in predicting elevated LV lling pressures and identifying patients with HFpEF. In our community-based population, LASI was also correlated with plasma NTproBNP and other echocardiographic parameters demonstrating raised left ventricular lling pressures (E', LAVI, TR velocity).…”

Section: Role Of Lasi As a Single Indexmentioning

confidence: 99%

Reduced Left Atrial Contractile Strain With Speckle Tracking Analysis Predicts Abnormal Plasma NTproBNP in an Asymptomatic Community Population

Liu

Zhang

Yang

et al. 2022

Preprint

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Background: The left atrium (LA) is closely related to left ventricular diastolic function. Two-dimensional speckle tracking strain and strain rate (SR) imaging have been applied in the study of LA function. We intended to explore the relationship between global LA deformation parameters and plasma NTproBNP levels in asymptomatic community residents with normal ejection fraction and normal LA volume.Methods: A cross-sectional sample of Beijing residents underwent comprehensive Doppler echocardiography and medical record review in 2009.Global LA longitudinal strain and SR indexes were obtained in the apical four-chamber view. LA stiffness index (LASI) was calculated as the ratio of early diastolic velocity of transmitral flow/early diastolic mitral annular motion velocity (E/E') to LA reservoir strain. Results: A total of 620 individuals (mean age=65 years, left ventricular ejection fraction=70.8%, LA volume index=17.9ml/m2) were investigated in our study. 117 individuals had increased plasma NTproBNP (≥125pg/ml). LA reservoir and contractile function by LA strain and SR indexes were significantly reduced in the abnormal NTproBNP group compared with the normal NTproBNP group. Multiple regression analysis indicated that LA contractile strain was a negative predictor of plasma NTproBNP in addition to indexed LA volume and E/E'. LASI was higher in the abnormal NTproBNP group and was significantly correlated with NTproBNP (r=0.342, P<0.001). The area under ROC analysis for LASI in predicting elevated plasma NTproBNP was 0.690, higher than that for LA strain, LA volume and E/E'. The cut-off value of LASI was 0.615.Conclusions: LA reservoir and contractile functions demonstrated by LA strain and SR were significantly impaired in the community-based population with increased plasma NTproBNP levels. LA contractile strain adds incremental information in predicting abnormal NTproBNP levels. LASI was the best single index in the detection of abnormal NTproBNP.

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Left atrial reservoir strain combined with E/E' as a better single measure to predict elevated LV filling pressures in patients with coronary artery disease

Cited by 34 publications

References 45 publications

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

Multi-modality assessment and role of left atrial function as an imaging biomarker in cardiovascular disease

The role of left atrial strain in patients with functional tricuspid regurgitation before and after annuloplasty: a long-term follow-up study

Reduced Left Atrial Contractile Strain With Speckle Tracking Analysis Predicts Abnormal Plasma NTproBNP in an Asymptomatic Community Population

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