Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in end-stage renal disease patients with preserved left ventricular ejection fraction

Abid, Leïla; Charfeddine, S.; Kammoun, S.

doi:10.1007/s12574-016-0276-6

Cited by 14 publications

(14 citation statements)

References 33 publications

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“…The E/e' ratio is commonly used despite the fact that it is also preload-dependent as it was in this study, where we observed significant decrease of the lateral E/e' only due to significant decrease of transmitral E-velocity. A similar observation was reported very recently by Abid et al [18]. Interestingly, the LAEF also did not improve in Abid's study despite their patients being 20 years younger than ours.…”

Section: Discussionsupporting

confidence: 92%

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Left Atrial Dysfunction in End-Stage Renal Disease Patients Treated by Hemodialysis

Malík¹,

Lachmanová

Kudlicka³

et al. 2016

Nephron

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Background: Repeated inter-dialysis water retention contributes to the development of left ventricular hypertrophy and failure, which is responsible for significant mortality of end-stage renal disease (ESRD) patients. The left atrium has a thin wall, which makes it even more prone to preload changes. In the general population with heart failure with preserved ejection fraction (HFpEF), left atrial function is even worse than that in patients with reduced ejection fraction. We hypothesized that repeated water retention is related to left atrial dysfunction in ESRD patients treated by hemodialysis and that the expected changes would be related to the brain natriuretic peptide (BNP) levels. Methods: Forty six patients were enrolled. Left atrial end-diastolic and end-systolic volumes and left atrial ejection fraction (LAEF) were recorded by echocardiography just before and just after dialysis and then analyzed offline. Moreover, BNP was analyzed also prior to dialysis and after. Effects of dialysis were tested using paired t test and the correlation analysis was applied to test associations. Results: LAEF was inversely related to the dialysis vintage (r = -0.62, p = 0.001) and patient's age (r = -0.48, p = 0.005) and it did not increase after dialysis despite the decrease of left atrial volume. BNP was related to left atrial volume index (r = 0.45, p = 0.019) and to LAEF (r = -0.57, p = 0.003). Conclusions: LAEF is decreased especially in long-term dialyzed patients and does not improve after dialysis despite the decrease of left atrial volume. Inadequate contractility reserve of the left atrium is similar to the non-ESRD patients with HFpEF and might help explain the high prevalence of heart failure in ESRD patients.

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Section: Discussionsupporting

confidence: 92%

“…In our opinion, the age distribution of our patients better represent the hemodialysis population in developed countries. Abid et al [18] observed improved left atrial peak strain during left ventricular systole (LAGS) after hemodialysis. Unfortunately, we do not have similar data.…”

Section: Discussionmentioning

confidence: 99%

Left Atrial Dysfunction in End-Stage Renal Disease Patients Treated by Hemodialysis

Malík¹,

Lachmanová

Kudlicka³

et al. 2016

Nephron

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“…Recent studies have demonstrated the presence of abnormal LA mechanical properties in HFpEF, and potential usefulness of LA strain in the detection of diastolic dysfunction . Abnormal LA strain has also been shown to correspond to natriuretic peptide levels and exercise capacity in HFpEF . However, the mechanism responsible for the relationship between LA mechanical properties and exercise haemodynamic responses in HFpEF is uncertain.…”

Section: Introductionmentioning

confidence: 99%

Impaired left atrial strain predicts abnormal exercise haemodynamics in heart failure with preserved ejection fraction

Telles

Nanayakkara

Evans

et al. 2019

European J of Heart Fail

120

107

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Background Elevated left atrial (LA) pressure, particularly during exercise, is associated with symptomatic status and survival in patients with heart failure with preserved ejection fraction (HFpEF). We aimed to characterize the contribution of abnormal LA mechanical properties to exercise haemodynamics in HFpEF. Methods and results Simultaneous echocardiography and right heart catheterization were performed in 71 subjects with left ventricular ejection fraction ≥ 50% referred for assessment of exertional dyspnoea. According to haemodynamic evaluation, 49 patients were diagnosed with HFpEF [pulmonary capillary wedge pressure (PCWP) ≥ 15 mmHg at rest and/or ≥ 25 mmHg at maximal exertion] and 22 as non‐cardiac dyspnoea. Apical two‐ and four‐chamber views were used for blinded two‐dimensional LA speckle tracking analysis. HFpEF was characterized by impaired LA reservoir (24.3 ± 9.6 vs. 36.7 ± 8.4%, P < 0.001) and pump strain (−11.5 ± 3.2 vs. −17.0 ± 3.4%, P < 0.001); and increased stiffness (0.8 ± 0.7 vs. 0.2 ± 0.1 mmHg/%, P < 0.001). Reservoir and pump strain correlated with exercise PCWP (r = −0.64 and r = 0.72, P < 0.001), and remained independent predictors after adjusting for left ventricular mass index, LA volume index, mean E/e' and systolic blood pressure (B = −0.66 and B = 1.41, respectively, P < 0.001). LA stiffness was strongly related to B‐type natriuretic peptide levels (r = 0.73, P < 0.001; B = 173.0, P < 0.001). Reservoir strain at cut‐off of ≤ 33% predicted invasively verified HFpEF diagnosis with 88% sensitivity and 77% specificity, providing a net reclassification improvement of 12% in comparison to the 2016 European Society of Cardiology criteria for non‐invasive diagnosis of HFpEF. Conclusions Impaired LA reservoir and pump function and increased stiffness are associated with abnormal exercise haemodynamics in HFpEF. These markers provide significant HFpEF diagnostic utility in elderly ambulatory patients with dyspnoea.

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“…[ 9 ] Intermittent hypoxia associated with OSAHS may play the vital role in the coagulation function of arterial blood vessels and the development of atherosclerosis. [ 10 ] The accelerated development of atherosclerosis can explain the connection between OSAHS and CVD. [ 11 ] In summary, OSAHS is significantly associated with cardiovascular and cerebrovascular events morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

“…[ 18 ] The previous development of 2D-STI provides the methods of evaluating left ventricular tissue function. [ 10 ] 2D-STI is a relatively new method of angle-independent quantification of left ventricular tissue strain, the angle of rotation, and mechanical parameters of myocardium. [ 19 ] Analysis of arterial wall mechanics using 2D-STI become available not only to acquire radial and longitudinal displacement but also to calculate circumferential strain.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of carotid arterial elasticity in patients with obstructive sleep apnea hypopnea syndrome by two-dimensional speckle tracking imaging

et al. 2017

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The objective is to evaluate carotid arterial elasticity in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) by two-dimensional speckle tracking imaging (2D-STI).Sixty-two hospitalized patients with OSAHS and 20 healthy subjects were studied. The OSAHS patients were divided into 3 subgroups: a mild group, a moderate group, and severe group. All subjects underwent complete left common carotid artery (LCCA) examination by echo-tacking technique and 2D-STI. The stiffness parameter (β), elastic modulus (Eρ), stiffness β single pulse wave velocity (PWVβ), and arterial compliance (AC) were automatically calculated by echo-tracking technique. And the global and segmental peak systolic circumferential artery strain (CAS) values were made off-line using 2D-STI.The β, Ep, and PWVβ values of the carotid artery in the moderate and severe groups were greater than those in the control group (P < .05). In addition, the systolic peak global CAS and the segments between 5 and 7 o’clock in the moderate and severe groups were lower than those in the control group (P < .05). Compared with mild group, the β, PWVp, and Ep values of the carotid artery in the moderate and severe groups were higher (P < .05) and the systolic peak global CAS lower than in the control group (P < .05). The systolic peak global CAS was significantly inversely correlated with stiffness (β, r = − 0.61, P < .05) and stiffness β single pulse wave velocity (PWVβ, r = −0.59, P < .05). Through stepwise multiple linear regression analysis, age and SaO2 were the significant variables that determined the systolic peak global CAS2D-STI provides a new method to investigate carotid arterial elasticity in patients with OSAHS.

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Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in end-stage renal disease patients with preserved left ventricular ejection fraction

Abstract: We observed that left atrium global peak systolic strain values decreased consistently with deteriorating systolic and diastolic function. Our results suggest that LAGS measurements may be helpful as a complimentary method to evaluate diastolic function.

Cited by 14 publications

References 33 publications

Left Atrial Dysfunction in End-Stage Renal Disease Patients Treated by Hemodialysis

Left Atrial Dysfunction in End-Stage Renal Disease Patients Treated by Hemodialysis

Impaired left atrial strain predicts abnormal exercise haemodynamics in heart failure with preserved ejection fraction

Evaluation of carotid arterial elasticity in patients with obstructive sleep apnea hypopnea syndrome by two-dimensional speckle tracking imaging

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