scholarly journals Incremental Diagnostic Value of Left Atrial Strain Over Left Atrial Volume

2018 ◽  
Vol 11 (10) ◽  
pp. 1416-1418 ◽  
Author(s):  
Kazuaki Negishi
Keyword(s):  
Left Atrial ◽  
Left Atrial Volume ◽  
Diagnostic Value ◽  
Atrial Volume ◽  
Left Atrial Strain ◽  
Atrial Strain

scholarly journals 417 Multi-chamber speckle tracking imaging and diagnostic value of left atrial strain in cardiac amyloidosis

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Alberto Aimo ◽  
Iacopo Fabiani ◽  
Alberto Giannoni ◽  
Giulia Elena Mandoli ◽  
Maria Concetta Pastore ◽  
...  
Keyword(s):  
Left Atrial ◽  
Speckle Tracking ◽  
Diagnostic Value ◽  
Diagnostic Significance ◽  
Left Atrial Strain ◽  
Diagnostic Score ◽  
Amyloid Deposits ◽  
Atrial Contraction ◽  
Atrial Strain ◽  
First Time

Abstract Aims Amyloid deposits in all cardiac chambers, impairing their function. We investigated for the first time if a speckle-tracking echocardiography (STE) analysis extended to all four chambers might hold additive diagnostic value for CA and its subtypes [amyloid transthyretin (ATTR-) and light-chain (AL)-CA]. Methods and results We evaluated 423 consecutive patients undergoing a diagnostic workup for CA in two referral centres from 2015 to 2020. CA was diagnosed in 261 patients (62%; ATTR-CA, n = 144, 34%; AL-CA, n = 117, 28%). Patients with CA had an impaired function of all cardiac chambers, particularly those with ATTR-CA. Peak left atrial longitudinal strain (LA-PALS) was the only STE parameter that predicted CA and ATTR-CA independent of laboratory and standard echocardiographic variables (Model 1). It also predicted ATTR-CA among patients with unexplained hypertrophy regardless of a diagnostic score (IWT score). Patients with either LA-PALS or LA-peak atrial contraction strain (PACS) in the first quartile (LA-PALS <6.65% or LA-PACS <3.62%) had an almost 4-fold higher likelihood of CA and ATTR-CA regardless of Model 1. Among patients with unexplained hypertrophy, those with LA-PALS or LA-PACS in the first quartile had an almost 9-fold higher likelihood of ATTR-CA irrespective of Model 1, and a 2-fold higher likelihood of ATTR-CA beyond the IWT score. Conclusions STE measures of all two chambers are abnormal in patients with CA, particularly in those with ATTR-CA. LA strain holds independent diagnostic significance. Among patients screened for CA, those with LA-PALS <6.65% and/or LA-PACS <3.62% have a high likelihood of CA and ATTR-CA.

Left atrial mechanics improvement after initiation of sacubitril-valsartan

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Ferreira Fonseca ◽  
J.M Farinha ◽  
S Goncalves ◽  
R Marinheiro ◽  
A Esteves ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Atrial ◽  
Structural Changes ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Population Characteristics ◽  
Volume Index ◽  
Left Atrial Strain ◽  
Left Atrial Volume Index ◽  
Atrial Strain

Abstract Introduction Heart failure with reduced ejection fraction (HFrEF) is associated with significant morbidity and mortality. Recently, in the PARADIGM-HF, sacubitrilvalsartan was superior to enalapril in reducing death and hospitalization for heart failure, and there is a growing interest in determining the structural changes besides reverse left ventricular remodelling. Purpose To determine if, in patients treated with sacubitril-valsartan, there was a change in left atrial (LA) mechanics quantified by two-dimensional strain echocardiography (2D-STE). Methods A total of 38 consecutive patients with HFrEF, followed in an outpatient heart failure clinic, were recruited. Population characteristics are summarized in Table 1. 2D-STE was used to measure left atrial strain in the reservoir phase (LASr) (Figure 1) and strain rate (LA-SR) before and 3 months after initiation of sacubitril-valsartan. Results There was a significant improvement in LASr (11.3±6.5% vs 14.2±7.4%, p=0.006) and LA-SR (0.55±0.25 s-1 vs 0.69±0.31 s-1, p=0.008) after initiation of sacubitril-valsartan. There was also a significant reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (1443.5 pg/ml (Interquartile range [IQR], 772–2912) vs 1112.0 pg/ml (IQR, 510–1455), p=0.016) and a tendency towards reduction in left atrial volume index (LAVI) (54.6±17.0 ml/m2 vs 51.4±18.8 ml/m2, p=0.053). The change in LASr and LA-SR was not related with the dose of sacubitril-valsartan (p=0.089). Conclusion In this population of HFrEF patients LA mechanics, as determined by 2D-STE, as well as NT-proBNP levels, significantly improved after treatment with sacubitril-valsartan. Figure 1. Left atrial strain Funding Acknowledgement Type of funding source: None

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