Left atrial strain in heart failure with preserved ejection fraction

Aung, Soe Moe; Güler, Ahmet; Güler, Yeliz; Huraibat, Ahmad; Karabay, CY; Akdemir, İlyas

doi:10.1007/s00059-016-4456-y

Cited by 33 publications

(27 citation statements)

References 22 publications

(25 reference statements)

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“…Most studies ( n = 19) set a LVEF cut‐off for HFpEF diagnosis of ≥ 50% while the remaining used ≥ 45% as their cut‐off. Study characteristics and patient demographics of included studies are summarized in Table . Methodological quality assessment showed low to moderate risk of bias among trials (online supplementary ) and observational studies (online supplementary ).…”

Section: Resultsmentioning

confidence: 99%

“…0% Table 1. 4,8,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Methodological quality assessment showed low to moderate risk of bias among trials (online supplementary Table S2) and observational studies (online supplementary Table S3). Inspection of funnel plot and Egger's test showed no evidence of publication bias (P = 0.07) although the number of included studies was small to allow adequate power of this test (online supplementary Figure S2).…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

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Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Khan

Memon

Murad

et al. 2020

European J of Heart Fail

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Aims Left atrial (LA) mechanical function may play a significant role in the development and progression of heart failure with preserved ejection fraction (HFpEF). We performed a systematic review and meta‐analysis to evaluate association of impaired LA function with outcomes in HFpEF. Methods and results Multiple databases were searched for original studies measuring different phases of LA function in HFpEF patients. Comparative LA function between HFpEF patients and healthy controls was assessed by pooling weighted mean differences (WMD). Adjusted hazard ratios (HRs) with 95% confidence intervals were pooled to evaluate the prognostic utility of LA function. Twenty‐two studies (2 trials, 20 observational) comprising 1974 HFpEF patients and 751 healthy controls were included. HFpEF patients had decreased LA reservoir [WMD = −12.21% (−15.47, −8.95); P < 0.001], LA conduit [WMD = −5.68% (−8.56, −2.79); P < 0.001], and pump [WMD = −11.07% (−14.81, −7.34); P < 0.001] emptying fractions compared with controls. LA reservoir [WMD = −13.38% (−16.07, −10.68); P < 0.001], conduit [WMD = −4.09% (−6.77, −1.42); P = 0.003], and pump [WMD = −3.53% (−4.47, −2.59); P < 0.001] strains were also significantly lower in HFpEF patients. Decreased LA reservoir strain [HR 1.24 (1.02, 1.50); P = 0.03] was significantly associated with risk of composite all‐cause mortality or heart failure hospitalization. Conclusions Impaired LA function appears to have diagnostic and prognostic value in HFpEF, but whether indices of LA function truly refine discrimination for diagnosis or prognosis remains to be fully determined. Larger studies are needed to better evaluate associations between LA function and clinical outcomes and the role of LA function as a target for novel HFpEF therapies.

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Section: Resultsmentioning

confidence: 99%

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Khan

Memon

Murad

et al. 2020

European J of Heart Fail

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“…The main manifestation of LA dysfunction is the increase in its volume, which is an indicator of the severity of HFpEF and plays an important role in disease progression in HFpEF patients. 14,15 The LAVI is the volume of the LA corrected by body surface area; it eliminates interindividual differences in height and body mass. Thus, the LAVI accurately reflects the degree of LV diastolic dysfunction.…”

Section: Determination Of Correlation Between Nt-probnp and 2de/twimentioning

confidence: 99%

Twist/untwist parameters are promising evaluators of myocardial mechanic changes in heart failure patients with preserved ejection fraction

Zeng

Xie

et al. 2020

Clinical Cardiology

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Background: This study aimed to evaluate the twist/untwist parameters of the left ventricle (LV) in patients with heart failure with preserved ejection fraction (HFpEF) measured by ultrasonic two-dimensional speckle tracking echocardiography (STE) and to examine the correlations between twist parameters and serum N-terminal pro b-type natriuretic peptide (NT-proBNP) as well as conventional two-dimensional echocardiography (2DE) indexes. Hypothesis: Changes in twist/untwist parameters can be used to evaluate LV function in HFpEF patients. Methods: In 63 HFpEF patients and 40 healthy controls, we analyzed LV twist/ untwist parameters by STE, cardiac function by 2DE, and serum NT-proBNP by enzyme-linked immunosorbent assay (ELISA). The correlations between twist/ untwist parameters and 2DE parameters and serum NT-proBNP were examined by Pearson correlation analysis. Results: Left ventricular end diastolic inner diameter and ejection fraction in HFpEF patients were within the normal range, whereas other 2DE parameters including left ventricular posterior wall end diastolic thickness, interventricular septal thickness, left atrial volume index, E, E/A, and E/e' differed significantly between HFpEF patients and control subjects. The twist/ untwist parameters such as peak apical rotation (Par), peak untwisting velocity (PUWV), and isovolumic diastole untwisting percentage (Iutw%) were significantly decreased in HFpEF patients compared with control participants. Positive correlations between PUWV/Iutw% and E/A/E/e' and a significant negative correlation between PUWV/Iutw% and left atrial volume index (LAVI) were observed. The plasma NT-proBNP concentration was positively correlated with LAVI, but negatively correlated with PUWV and Iutw%. Conclusions: Changes in twist/untwist parameters correlate well with conventional 2DE parameters and plasma levels of NT-proBNP, and can be used to evaluate LV function in HFpEF patients. Par is sensitive to the LV myocardial function damage.

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“…Speckle-tracking echocardiography is a promising diagnostic tool for detailed LA function evaluation [4,5]. This technique was successfully tested in various pathological conditions [6][7][8]. However, the methodology of LA strain analysis needs standardization.…”

Section: Introductionmentioning

confidence: 99%

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

Kolesnyk

Sokolova

2018

ZMJ

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Left atrium (LA) state reflects the severity of cardiovascular remodeling and indicates the degree of compensation in many cardiovascular diseases, including arterial hypertension (AH). Transthoracic echocardiography determines linear and volumetric parameters of LA, but it has limitations in early stages of AH. Speckle tracking echocardiography is a new technique which can identify early subclinical dysfunction of cardiac chambers.The purpose of the study was 1) to assess feasibility, intra-and inter-observer reproducibility of LA longitudinal strain (LS) derived by both P-and R-wave triggering method; 2) to compare LA strain values obtained by P-and R-wave synchronization in hypertensive postmenopausal women. Material and methods.The study involved 65 post-menopausal hypertensive women (mean age -56.8 ± 8.15 years). All patients underwent a standard transthoracic and two-dimensional speckle tracking echocardiography using Vivid E9 XDClear Console 4D Expert 100 (General Electric, USA). Apical four-and two-chamber views images were obtained during breath hold with ECG synchronization. All statistical analyses were performed using SPSS 20 for Windows (SPSS, Inc., Chicago, IL).Results. Initial feasibility of echocardiographic data for performing LA strain analysis was 93.85 %. Adequate tracking quality was achieved in 96.93 % of segments by P-triggering and in 96.35 % by R -wave as initial point of analysis. The intra-class correlation (ICC) coefficient for R-triggering was 0.96 (95 % CI 0.89-0.98) for intra-observer and 0.94 (95 % CI -0.52-0.97) for inter-observer variability. The ICC coefficients for P-triggering were higher 0.97 (95 % CI 0.92-0.99) and 0.96 (95 % CI -0.9-0.98), respectively. The Bland-Altman statistic confirmed absence of bias in both variants of ECG-triggering. Values of LA LS calculated by R-triggering method were significantly higher than those ones by P-triggering (P < 0.001). Conclusions.Speckle tracking echocardiography is a reliable technique, which provides quantitative assessment of LA physiology. The P-wave triggering method of LA strain analysis is more reproducible compared with R-wave triggering variant. The LA LS values differ significantly depending on ECG-triggering type (P-or R wave), providing higher values by R-wave triggering method.Надійність двовимірної спекл-трекінг ехокардіографії при оцінюванні функції лівого передсердя в жінок у стані менопаузи з гіпертонічною хворобоюСтан лівого передсердя (ЛП) показує тяжкість серцево-судинного ремоделювання та вказує на ступінь компенсації багатьох серцево-судинних захворювань, у тому числі гіпертонічної хвороби (ГХ). Трансторакальна ехокардіографія визначає лінійні та об'ємні параметри ЛП, але має обмеження на ранніх стадіях ГХ. Спекл-трекінг ехокардіографія -це нова методика, що дає змогу ідентифікувати ранню субклінічну дисфункцію камер серця.Мета роботи -оцінити технічну можливість визначення, а також внутрішньо-та міждослідницьку відтворю-ваність поздовжнього стрейна ЛП, синхронізованого з P-та R-зубцями ЕКГ; порівняти значення...

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Left atrial strain in heart failure with preserved ejection fraction

Abstract: LA function as assessed by 2D-STE is impaired in patients with HFpEF. A GLAs-res value of < 17.5 % can be useful for the diagnosis of HFpEF.

Cited by 33 publications

References 22 publications

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Twist/untwist parameters are promising evaluators of myocardial mechanic changes in heart failure patients with preserved ejection fraction

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

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Left atrial strain in heart failure with preserved ejection fraction

Abstract: LA function as assessed by 2D-STE is impaired in patients with HFpEF. A GLAs-res value of < 17.5 % can be useful for the diagnosis of HFpEF.

Cited by 33 publications

References 22 publications

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Twist/untwist parameters are promising evaluators of myocardial mechanic changes in heart failure patients with preserved ejection fraction

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

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Abstract: LA function as assessed by 2D-STE is impaired in patients with HFpEF. A GLAs-res value of < 17.5 % can be useful for the diagnosis of HFpEF.