Prognostic value of diastolic function parameters in significant aortic regurgitation: the role of the left atrial strain

García-Martín, Ana; Sequeiros, M Abellas; Gómez, Ariana González; Díaz, Luis Miguel Rincón; Ruiz, Juan Manuel Monteagudo; Baydes, R Hinojar; Mur, José Luis Moya; Zamorano, José Luís; Fernández-Golfín, Covadonga

doi:10.1007/s12574-022-00577-6

Cited by 5 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this context, LALS might be a sensitive marker of preclinical insult, translating diastolic impairment and a rise in filling pressures [ 33 , 34 ], as shown in children [ 27 , 28 ]. Atrial strain has emerged as a sensitive tool in early detection of subtle or early changes in the setting of various cardiac conditions such as atrial fibrillation, valvulopathies, systemic diseases, heart failure with preserved ejection fraction and diastolic dysfunction [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. LALS changes usually precede other structural variations such as left atrial volume increase and systolic dysfunction in heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Left atrial longitudinal strain (LALS) has recently emerged as a useful tool, generating independent added value in different scenarios such as valvulopathies, atrial fibrillation, heart failure and systemic diseases [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. It has also been postulated as a means for evaluating diastolic function and left ventricular filling pressures [ 11 , 12 , 13 , 14 ], reported to be altered in acute cellular rejection (ACR) episodes in heart transplant (HTx) recipients [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Left Atrial Longitudinal Strain in the Diagnosis of Acute Cellular Rejection in Heart Transplant Recipients

Diego

Ruiz‐Ortiz

Delgado-Ortega

et al. 2022

JCM

View full text Add to dashboard Cite

Our aim was to investigate the role of left atrial longitudinal strain (LALS) in the non-invasive diagnosis of acute cellular rejection (ACR) episodes in heart transplant (HTx) recipients. Methods: We performed successive echocardiographic exams in 18 consecutive adult HTx recipients in their first year after HTx within 3 h of the routine surveillance endomyocardial biopsies (EMB) in a single center. LALS parameters were analyzed with two different software. We investigated LALS association with ACR presence, as well as inter-vendor variability in comparable LALS values. Results: A total of 147 pairs of EMB and echo exams were carried out. Lower values of LALS were significantly associated with any grade of ACR presence. Peak atrial longitudinal strain (PALS) offered the best diagnostic value for any grade of ACR, with a C statistic of 0.77 using one software (95% CI 0.68–0.84, p < 0.0005) and 0.64 with the other (95% CI 0.54–0.73, p = 0.013) (p = 0.02 for comparison between both curves). Reproducibility between comparable LALS parameters was poor (intraclass correlation coefficients were 0.60 for PALS, 95% CI 0.42–0.73, p < 0.0005; and 0.42 for PALS rate, 95% CI −0.13–0.68, p < 0.0005). Conclusions: LALS variables might be a sensitive marker of ACR in HTx recipients, principally discriminating between those studies without rejection and those with any grade of ACR. Inter-vendor variability was significant.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Role of Left Atrial Longitudinal Strain in the Diagnosis of Acute Cellular Rejection in Heart Transplant Recipients

Diego

Ruiz‐Ortiz

Delgado-Ortega

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…Strain imaging is not limited to the LV. Left atrial (LA) reservoir strain has been documented to be impaired in patients with chronic asymptomatic severe AR, but lower values of LA strain are associated with adverse prognosis, and show promise in risk stratification of patients with severe AR [ 100 – 102 ]. Figure 1 provides a summary of all the parameters of significance in the echocardiographic assessment of AR (Fig.…”

Section: Echocardiographic Assessment Of Aortic Regurgitationmentioning

confidence: 99%

“…Probability of LVEF deterioration was significantly greater in patients with GLS Alashi et al [ 96 ] 2019 6.95 years 865 patients with severe AR and LVEF ≥ 50% who underwent AVR Baseline LV-GLS value worse than -19% was associated with reduced survival. In a subgroup of patients who returned for 3- and 12-month follow-up examinations, persistently impaired LV-GLS was associated with increased mortality Kalkan et al [ 101 ] 2021 N/A 64 patients with mild, moderate and severe AR This study showed that LA-Res and LA pump parameters of the patients with severe AR significantly decreased compared to those of the mild and moderate AR group Jenner et al [ 100 ] 2021 1 year 65 patients with severe AR who underwent AVR Preoperative left atrial strain during the conduit phase added to LVESVi for the prediction of impaired LV functional and structural recovery after aortic valve replacement (accuracy 70%; addition of left atrial strain during the conduit phase to LVESVi p = 0.006) Martín et al [ 102 ] 2022 2.8 years 126 asymptomatic patients with chronic severe AR LVEDV and E/e’ ratio were significant predictors of adverse events. Lower LA reservoir strain values (less than median of 34%) were associated with higher rates of events (hospital admission due to heart failure, cardiovascular mortality, or aortic valve surgery) AR aortic regurgitation; AS Aortic stenosis; GLS Global longitudinal strain; LV Left ventricular; LVEDDi Left ventricular end-diastolic diameter indexed to body surface area; LVEF Left ventricular ejection fraction; LVEDV Left ventricular end-diastolic volume; LVESVi Left ventricular end-systolic volume indexed to body surface area …”

Section: Echocardiographic Assessment Of Aortic Regurgitationmentioning

confidence: 99%

Echocardiographic assessment of aortic regurgitation: a narrative review

Tsampasian,

Victor,

Bhattacharyya

et al. 2024

Echo Res Pract

View full text Add to dashboard Cite

Aortic regurgitation (AR) is the third most frequently encountered valve lesion and may be caused by abnormalities of the valve cusps or the aorta. Echocardiography is instrumental in the assessment of AR as it enables the delineation of valvular morphology, the mechanism of the lesion and the grading of severity. Severe AR has a major impact on the myocardium and carries a significant risk of morbidity and mortality if left untreated. Established and novel echocardiographic methods, such as global longitudinal strain and three-dimensional echocardiography, allow an estimation of this risk and provide invaluable information for patient management and prognosis. This narrative review summarises the epidemiology of AR, reviews current practices and recommendations with regards to the echocardiographic assessment of AR and outlines novel echocardiographic tools that may prove beneficial in patient assessment and management.

show abstract

“…The optimal timing of surgery in asymptomatic aortic regurgitation is challenging [ 119 ]. Ana Garcia Martin et al have shown that diastolic function indices, including PALS, are prognostic markers of adverse events in asymptomatic severe aortic regurgitation [ 187 ]. Similarly to aortic stenosis, plasma levels of natriuretic peptides also increase with the severity of aortic regurgitation [ 30 , 188 ].…”

Section: Valvular Heart Disease and Atrial Cardiomyopathymentioning

confidence: 99%

Atrial Cardiomyopathy in Valvular Heart Disease: From Molecular Biology to Clinical Perspectives

Molnár

Sánta

Pásztor

et al. 2023

Cells

View full text Add to dashboard Cite

This review discusses the evolving topic of atrial cardiomyopathy concerning valvular heart disease. The pathogenesis of atrial cardiomyopathy involves multiple factors, such as valvular disease leading to atrial structural and functional remodeling due to pressure and volume overload. Atrial enlargement and dysfunction can trigger atrial tachyarrhythmia. The complex interaction between valvular disease and atrial cardiomyopathy creates a vicious cycle of aggravating atrial enlargement, dysfunction, and valvular disease severity. Furthermore, atrial remodeling and arrhythmia can predispose to atrial thrombus formation and stroke. The underlying pathomechanism of atrial myopathy involves molecular, cellular, and subcellular alterations resulting in chronic inflammation, atrial fibrosis, and electrophysiological changes. Atrial dysfunction has emerged as an essential determinant of outcomes in valvular disease and heart failure. Despite its predictive value, the detection of atrial fibrosis and dysfunction is challenging and is not included in the clinical routine. Transthoracic echocardiography and cardiac magnetic resonance imaging are the main diagnostic tools for atrial cardiomyopathy. Recently published data have revealed that both left atrial volumes and functional parameters are independent predictors of cardiovascular events in valvular disease. The integration of atrial function assessment in clinical practice might help in early cardiovascular risk estimation, promoting early therapeutic intervention in valvular disease.

show abstract

Prognostic value of diastolic function parameters in significant aortic regurgitation: the role of the left atrial strain

Cited by 5 publications

References 18 publications

The Role of Left Atrial Longitudinal Strain in the Diagnosis of Acute Cellular Rejection in Heart Transplant Recipients

The Role of Left Atrial Longitudinal Strain in the Diagnosis of Acute Cellular Rejection in Heart Transplant Recipients

Echocardiographic assessment of aortic regurgitation: a narrative review

Atrial Cardiomyopathy in Valvular Heart Disease: From Molecular Biology to Clinical Perspectives

Contact Info

Product

Resources

About