Left atrial strain predicts risk and prognosis in patients with acute coronary syndrome: A retrospective study with external validation

Li, Yi-Tong; Shen, Wenqian; Duan, Xin; Li, Yang; Wang, Yanxia; Ren, Xing-Xing; Liu, Qiqi; Tian, Jiawei; Du, Guoqing

doi:10.1016/j.heliyon.2022.e11276

Cited by 5 publications

(5 citation statements)

References 49 publications

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“…Unfortunately, the number of studies investigating the prognostic ability of PCS and PACS is limited and no study has previously investigated the prognostic value of PCS and PACS regarding mortality outcomes among patients with ischemic heart disease. However, a study by Li et al [ 9 ] of 229 ACS patients examined by echocardiography median of 1 day before PCI, demonstrated PALS to have the strongest correlation with global registry of acute coronary events (GRACE) score out of all investigated echocardiographic variables (which included a vast number of structural and functional echocardiographic measurements), closely followed by PCS and PACS. Finally, Svartstein et al [ 23 ] examined 392 STEMI patients following PCI and observed decreasing PALS, PCS, and PACS to be associated with incident atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

“…Studies have found LA strain to yield predictive value for development of complications associated with increased mortality such as MACE, atrial fibrillation and HF in ACS cohorts [ 11 , 23 , 27 ]. The previously mentioned study by Li et al [ 9 ] . found PALS to be superior to LAVI by comparing their correlation with GRACE risk scores in predicting short term MACE [ 18 , 28 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is known that impaired left atrial (LA) function following ACS is associated with major adverse cardiovascular events (MACE) [ 8 ]. Risk stratifying ACS patients based upon LA function will assist in identifying patients at high risk of mortality [ 9 ]. The non-invasive method of two-dimensional speckle tracking echocardiography (2D STE) provides a detailed assessment of LA function [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Left atrial strain is associated with long-term mortality in acute coronary syndrome patients

Pedersson,

Skaarup,

Lassen

et al. 2024

Int J Cardiovasc Imaging

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To investigate the long-term prognostic value of the left atrial (LA) strain indices – peak atrial longitudinal strain (PALS), peak conduit strain (PCS), and peak atrial contractile strain (PACS) in acute coronary syndrome (ACS) patients in relation to all-cause mortality. This retrospective study included ACS patients treated with percutaneous coronary intervention (PCI) and examined with echocardiography. Exclusion criteria were non-sinus rhythm during echocardiography, missing images, and inadequate image quality for 2D speckle tracking analysis of the LA. The endpoint was all-cause death. Multivariable Cox regression which included relevant clinical and echocardiographic measures was utilized to assess the relationship between LA strain parameters and all-cause mortality. A total of 371 were included. Mean age was 64 years and 76% were male. Median time to echocardiography was 2 days following PCI. During a median follow-up of 5.7 years, 83 (22.4%) patients died. Following multivariable analysis, PALS (HR 1.04, 1.01–1.06, p = 0.002, per 1% decrease) and PCS (HR 1.05, 1.01–1.09, p = 0.006, per 1% decrease) remained significantly associated with all-cause mortality. PALS and PCS showed a linear relationship with the outcome whereas PACS was associated with the outcome in a non-linear fashion such that the risk of death increased when PACS < 18.22%. All LA strain parameters remained associated with worse survival rate when restricting analysis to patients with left atrial volume index < 34 ml/m2. Reduced LA function as assessed by PALS, PCS, and PACS were associated with an increased risk of long-term mortality in patients with ACS. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Left atrial strain is associated with long-term mortality in acute coronary syndrome patients

Pedersson,

Skaarup,

Lassen

et al. 2024

Int J Cardiovasc Imaging

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“…15,16 Increasing evidence has suggested that LARS can provide additional prognostic value in patients with ischemic heart disease. 17,18 Duus et al 19 reported that LARS is independent predictor of heart failure and cardiovascular death after revascularization and add prognostic information even in patients with normal LA size.…”

Section: Introductionmentioning

confidence: 99%

“…LA reservoir strain (LARS), a high‐profile new parameter for evaluating LA subclinical function, has been proposed as an important determinant of outcomes 15,16 . Increasing evidence has suggested that LARS can provide additional prognostic value in patients with ischemic heart disease 17,18 . Duus et al 19 .…”

Section: Introductionmentioning

confidence: 99%

Incremental prognostic utility of left ventricular and left atrial strains in coronary artery disease patients with reduced systolic function

Lu,

Zhu,

Zhou

et al. 2024

Echocardiography

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ObjectiveThis study aimed to investigate the predictive value of left ventricular global longitudinal strain (GLS) and left atrial reservoir strain (LARS) on adverse events in chronic coronary artery disease (CAD) patients with reduced systolic function.MethodsA total of 192 consecutive patients clinically diagnosed with chronic CAD and left ventricular ejection fraction (LVEF) ≤ 50% were finally included. Multiple strain parameters were analyzed with speckle tracking echocardiography. The composite endpoint included all‐cause mortality, rehospitalization due to heart failure, myocardial infarction, and stroke.ResultsPatients experiencing the endpoint showed lower LVEF, lower absolute GLS and LARS than those without events. Both GLS (AUC = 0.82 [GLS] vs. 0.58 [LVEF], p < 0.001) and LARS (AUC = 0.71 [LARS] vs. 0.58 [LVEF], p = 0.033) were superior to LVEF in predicting adverse events. Multivariate cox regression analysis showed that both GLS (hazard ratio, 0.71; 95% CI, 0.63–0.79; p < 0.001) and LARS (hazard ratio, 0.96; 95% CI, 0.93–0.98; p < 0.001) were independent predictors for the endpoint. The addition of LARS (global chi‐squared, 35.7 vs. 17.4; p < 0.05), GLS (global chi‐squared, 58.6 vs. 17.4; p < 0.05) or both LARS and GLS (global chi‐squared, 79.6 vs. 17.4; p < 0.05) to LVEF in the prediction model significantly improved its performance. The same significant improvement was also shown in the subgroups of mild (30% < LVEF ≤ 50%) and severe (LVEF ≤ 30%) reduced systolic function.ConclusionsRegarding CAD patients with reduced LVEF, both GLS and LARS are superior to LVEF in predicting adverse events, providing significant incremental value to LVEF.

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Incremental diagnostic and prognostic utility of left atrial deformation in heart failure using speckle tracking echocardiography

Anwar

2024

Heart Fail Rev

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Left atrial strain predicts risk and prognosis in patients with acute coronary syndrome: A retrospective study with external validation

Cited by 5 publications

References 49 publications

Left atrial strain is associated with long-term mortality in acute coronary syndrome patients

Left atrial strain is associated with long-term mortality in acute coronary syndrome patients

Incremental prognostic utility of left ventricular and left atrial strains in coronary artery disease patients with reduced systolic function

Incremental diagnostic and prognostic utility of left atrial deformation in heart failure using speckle tracking echocardiography

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