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Erschienen in: Journal of Echocardiography 3/2019

31.10.2018 | Original Investigation

Association between left atrial strain and left ventricular diastolic function in patients with acute coronary syndrome

verfasst von: Rafael Modesto Fernandes, David Le Bihan, Andrea A. Vilela, Rodrigo B. M. Barretto, Elizabete S. Santos, Jorge E. Assef, Simone Rolim Fontes Pedra, Amanda G. M. R. Sousa, Ari Timerman

Erschienen in: Journal of Echocardiography | Ausgabe 3/2019

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Abstract

Background

Left ventricular diastolic function is an important prognostic marker in acute coronary syndrome. However, classification of the dysfunction grade using isolated echocardiographic parameters remains difficult. Therefore, it is necessary to combine multiple data in diagnostic algorithms. The purpose of this study was to evaluate the capacity of left atrial strain (LAS) components to classify left ventricular diastolic dysfunction (DD) grade.

Methods

Cross-sectional study with 109 consecutive patients admitted to the emergency room with acute coronary syndrome. Patients were referred for echocardiographic evaluation within 72 h. Mean values of LAS, corresponding to three phases of atrial function (reservoir, conduit and contraction), were obtained by speckle-tracking echocardiography. Patients were divided according to the diastolic dysfunction grade for later association with the LAS.

Results

The three LAS components showed moderate correlation with most diastolic variables (left atrial volume index, E/e′ ratio and e′ wave). In addition, there was related reduction of the LAS, which was inversely proportional to the DD grade (p < 0.05). LAS was effective for the identification of patients with DD grade III [area under the curve (AUC) for the reservoir = 0.99; conduit AUC = 0.89; contraction AUC = 0.99) and also those with DD grade II or III (reservoir AUC = 0.94; conduit AUC = 0.92; contraction AUC = 0.80].

Conclusions

LAS alone presented excellent capacity to classify DD in patients with acute coronary syndrome and may represent an additional tool for this purpose.
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Literatur
1.
Zurück zum Zitat Sanchis-Gomar F, Perez-Quilis C, Leischik R, et al. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4:256–66.CrossRefPubMedPubMedCentral Sanchis-Gomar F, Perez-Quilis C, Leischik R, et al. Epidemiology of coronary heart disease and acute coronary syndrome. Ann Transl Med. 2016;4:256–66.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Roffi M, Patrono C, Collet J-P, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016;37:267–315.CrossRefPubMed Roffi M, Patrono C, Collet J-P, et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016;37:267–315.CrossRefPubMed
3.
Zurück zum Zitat Heyndrickx GR, Baig H, Nellens P, et al. Depression of regional blood flow and wall thickening after brief coronary occlusions. Am J Physiol. 1978;234:H653–9.PubMed Heyndrickx GR, Baig H, Nellens P, et al. Depression of regional blood flow and wall thickening after brief coronary occlusions. Am J Physiol. 1978;234:H653–9.PubMed
4.
Zurück zum Zitat Cerisano G, Bolognese L, Carrabba N, et al. Doppler-derived mitral deceleration time: an early strong predictor of left ventricular remodeling after reperfused anterior acute myocardial infarction. Circulation. 1999;99:230–6 (American Heart Association, Inc).CrossRefPubMed Cerisano G, Bolognese L, Carrabba N, et al. Doppler-derived mitral deceleration time: an early strong predictor of left ventricular remodeling after reperfused anterior acute myocardial infarction. Circulation. 1999;99:230–6 (American Heart Association, Inc).CrossRefPubMed
5.
Zurück zum Zitat Nagueh SFMD, Middleton KJ, Kopelen HA, et al. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30:1527–33.CrossRefPubMed Nagueh SFMD, Middleton KJ, Kopelen HA, et al. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30:1527–33.CrossRefPubMed
6.
Zurück zum Zitat Hillis GS, Møller JE, Pellikka PA. Noninvasive estimation of left ventricular filling pressure by e/é is a powerful predictor of survival after acute myocardial infarction. ACC Curr J Rev. 2004;13:42.CrossRef Hillis GS, Møller JE, Pellikka PA. Noninvasive estimation of left ventricular filling pressure by e/é is a powerful predictor of survival after acute myocardial infarction. ACC Curr J Rev. 2004;13:42.CrossRef
7.
Zurück zum Zitat Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17:1321–60.CrossRefPubMed Nagueh SF, Smiseth OA, Appleton CP, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17:1321–60.CrossRefPubMed
8.
Zurück zum Zitat Almeida JG, Fontes-Carvalho R, Sampaio F, et al. Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population. Eur Heart J Cardiovasc Imaging. 2017;289:194. Almeida JG, Fontes-Carvalho R, Sampaio F, et al. Impact of the 2016 ASE/EACVI recommendations on the prevalence of diastolic dysfunction in the general population. Eur Heart J Cardiovasc Imaging. 2017;289:194.
9.
Zurück zum Zitat Casaclang-Verzosa G, Gersh BJ, Tsang TSM. Structural and functional remodeling of the left atrium. J Am Coll Cardiol. 2008;51:1–11.CrossRefPubMed Casaclang-Verzosa G, Gersh BJ, Tsang TSM. Structural and functional remodeling of the left atrium. J Am Coll Cardiol. 2008;51:1–11.CrossRefPubMed
10.
Zurück zum Zitat Leong DP, Penhall A, Perry R, et al. Speckle-tracking strain of the left atrium: a transoesophageal echocardiographic validation study. Eur Heart J Cardiovasc Imaging. 2013;14:898–905.CrossRefPubMed Leong DP, Penhall A, Perry R, et al. Speckle-tracking strain of the left atrium: a transoesophageal echocardiographic validation study. Eur Heart J Cardiovasc Imaging. 2013;14:898–905.CrossRefPubMed
11.
Zurück zum Zitat Sirbu C, Herbots L, Dhooge J, et al. Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur J Echocardiogr. 2006;7:199–208.CrossRefPubMed Sirbu C, Herbots L, Dhooge J, et al. Feasibility of strain and strain rate imaging for the assessment of regional left atrial deformation: a study in normal subjects. Eur J Echocardiogr. 2006;7:199–208.CrossRefPubMed
12.
Zurück zum Zitat Cameli M, Lisi M, Mondillo S, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound BioMed Cent. 2010;8:14.CrossRef Cameli M, Lisi M, Mondillo S, et al. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound BioMed Cent. 2010;8:14.CrossRef
13.
Zurück zum Zitat Hsiao S-H, Chiou K-R, Porter TR, et al. Left Atrial parameters in the estimation of left ventricular filling pressure and prognosis in patients with acute coronary syndrome. Am J Cardiol. 2011;107:1117–24.CrossRefPubMed Hsiao S-H, Chiou K-R, Porter TR, et al. Left Atrial parameters in the estimation of left ventricular filling pressure and prognosis in patients with acute coronary syndrome. Am J Cardiol. 2011;107:1117–24.CrossRefPubMed
14.
Zurück zum Zitat Wakami K, Ohte N, Asada K, et al. Correlation between left ventricular end-diastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009;22:847–51.CrossRefPubMed Wakami K, Ohte N, Asada K, et al. Correlation between left ventricular end-diastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009;22:847–51.CrossRefPubMed
15.
Zurück zum Zitat Cameli M, Sparla S, Losito M, et al. Correlation of left atrial strain and doppler measurements with invasive measurement of left ventricular end-diastolic pressure in patients stratified for different values of ejection fraction. Echocardiography. 2015;33:398–405 (5 ed).CrossRefPubMed Cameli M, Sparla S, Losito M, et al. Correlation of left atrial strain and doppler measurements with invasive measurement of left ventricular end-diastolic pressure in patients stratified for different values of ejection fraction. Echocardiography. 2015;33:398–405 (5 ed).CrossRefPubMed
16.
Zurück zum Zitat Kurt M, Tanboga IH, Aksakal E, et al. Relation of left ventricular end-diastolic pressure and N-terminal pro-brain natriuretic peptide level with left atrial deformation parameters. Eur Heart J Cardiovasc Imaging. 2012;13:524–30.CrossRefPubMed Kurt M, Tanboga IH, Aksakal E, et al. Relation of left ventricular end-diastolic pressure and N-terminal pro-brain natriuretic peptide level with left atrial deformation parameters. Eur Heart J Cardiovasc Imaging. 2012;13:524–30.CrossRefPubMed
17.
Zurück zum Zitat Singh A, Addetia K, Maffessanti F, et al. LA Strain for categorization of LV diastolic dysfunction. JACC Cardiovascr Imaging. 2017;10:735–43.CrossRef Singh A, Addetia K, Maffessanti F, et al. LA Strain for categorization of LV diastolic dysfunction. JACC Cardiovascr Imaging. 2017;10:735–43.CrossRef
18.
Zurück zum Zitat Morris DA, Belyavskiy E, Aravind-Kumar R, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC Cardiovasc Imaging. 2018;11(10):1405–15.CrossRefPubMed Morris DA, Belyavskiy E, Aravind-Kumar R, et al. Potential usefulness and clinical relevance of adding left atrial strain to left atrial volume index in the detection of left ventricular diastolic dysfunction. JACC Cardiovasc Imaging. 2018;11(10):1405–15.CrossRefPubMed
19.
Zurück zum Zitat Granger CB. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163:2345.CrossRefPubMed Granger CB. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163:2345.CrossRefPubMed
20.
Zurück zum Zitat Thygesen K, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33(20):2551–67.CrossRefPubMed Thygesen K, Chaitman BR, White HD, et al. Third universal definition of myocardial infarction. Eur Heart J. 2012;33(20):2551–67.CrossRefPubMed
21.
Zurück zum Zitat Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart J Cardiovascr Imaging. 2015;16:233–71.CrossRef Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. European Heart J Cardiovascr Imaging. 2015;16:233–71.CrossRef
22.
Zurück zum Zitat Lancellotti P, Galderisi M, Edvardsen T, et al. Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. Eur Heart J Cardiovasc Imaging. 2017;18:961–8.CrossRefPubMed Lancellotti P, Galderisi M, Edvardsen T, et al. Echo-Doppler estimation of left ventricular filling pressure: results of the multicentre EACVI Euro-Filling study. Eur Heart J Cardiovasc Imaging. 2017;18:961–8.CrossRefPubMed
23.
Zurück zum Zitat Ho SY, McCarthy KP, Faletra FF. Anatomy of the left atrium for interventional echocardiography. Eur J Echocardiogr. 2011;12:i11–5.CrossRefPubMed Ho SY, McCarthy KP, Faletra FF. Anatomy of the left atrium for interventional echocardiography. Eur J Echocardiogr. 2011;12:i11–5.CrossRefPubMed
24.
Zurück zum Zitat Vieira MJ, Teixeira R, Gonçalves L, et al. Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr. 2014;27:463–78.CrossRefPubMed Vieira MJ, Teixeira R, Gonçalves L, et al. Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr. 2014;27:463–78.CrossRefPubMed
25.
Zurück zum Zitat Liu Y-T, Li R-J, Fang F, et al. Left atrial function assessed by tissue doppler imaging as a new predictor of cardiac events after non-ST-elevation acute coronary syndrome. Echocardiography. 2012;29:785–92 (Blackwell Publishing Inc).CrossRefPubMed Liu Y-T, Li R-J, Fang F, et al. Left atrial function assessed by tissue doppler imaging as a new predictor of cardiac events after non-ST-elevation acute coronary syndrome. Echocardiography. 2012;29:785–92 (Blackwell Publishing Inc).CrossRefPubMed
26.
Zurück zum Zitat Donal E, Behagel A, Feneon D. Value of left atrial strain: a highly promising field of investigation. Eur Heart J Cardiovasc Imaging. 2015;16:356–7.CrossRefPubMed Donal E, Behagel A, Feneon D. Value of left atrial strain: a highly promising field of investigation. Eur Heart J Cardiovasc Imaging. 2015;16:356–7.CrossRefPubMed
27.
Zurück zum Zitat Galderisi M, Rapacciuolo A, Esposito R, et al. Site-dependency of the E/e’ ratio in predicting invasive left ventricular filling pressure in patients with suspected or ascertained coronary artery disease. Eur Heart J Cardiovasc Imaging. 2013;14:555–61.CrossRefPubMed Galderisi M, Rapacciuolo A, Esposito R, et al. Site-dependency of the E/e’ ratio in predicting invasive left ventricular filling pressure in patients with suspected or ascertained coronary artery disease. Eur Heart J Cardiovasc Imaging. 2013;14:555–61.CrossRefPubMed
Metadaten
Titel
Association between left atrial strain and left ventricular diastolic function in patients with acute coronary syndrome
verfasst von
Rafael Modesto Fernandes
David Le Bihan
Andrea A. Vilela
Rodrigo B. M. Barretto
Elizabete S. Santos
Jorge E. Assef
Simone Rolim Fontes Pedra
Amanda G. M. R. Sousa
Ari Timerman
Publikationsdatum
31.10.2018
Verlag
Springer Japan
Erschienen in
Journal of Echocardiography / Ausgabe 3/2019
Print ISSN: 1349-0222
Elektronische ISSN: 1880-344X
DOI
https://doi.org/10.1007/s12574-018-0403-7

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