scholarly journals Clinical implication of disturbed left atrial phasic functions in the heterogeneous population associated with hypertension or atrial fibrillation

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Mengruo Zhu ◽  
Haiyan Chen ◽  
Yang Liu ◽  
Xianhong Shu

Abstract Background To evaluate left atrial (LA) phasic functions in patients with hypertension and/or paroxysmal atrial fibrillation (PAF) and its clinical significance. Methods LA strain was studied in 77 patients (25 hypertension, 24 lone AF, and 28 with both hypertension and PAF) and 28 controls using two-dimensional speckle-tracking echocardiography (2D STE). The following indexes during atrial reservoir, conduit and pump phase were analyzed respectively: (1) peak atrial longitudinal strain (PALS) and strain rate (PALSR), (2) the standard deviation of time to PALS and PALSR of all LA segments (TpS-SD% and TpSR-SD%). Results Compared with controls, PALSres, PALScond and PALSRcond were significantly reduced in patients with isolated hypertension (all P < 0.01) but no significant differences were observed in PALSpump, PALSRpump and TpSpump-SD% between them (all P > 0.05). PALSpump, PALSRpump and PALSRres were significantly lower in patients with both hypertension and PAF than in those with isolated hypertension (all P < 0.05). PALS and PALSR were significantly decreased, and TpS-SD% was significantly increased during each phase in lone AF patients than in controls (all P < 0.05), and PALSRpump was further depressed in patients with both hypertension and PAF (P = 0.029). PALSRcond ≤ 1.475 s− 1 combined with TpSpump-SD% ≥ 3.25% (sensitivity, 85%; specificity, 71%; AUC = 0.845, P < 0.001) could distinguish lone AF from healthy subjects effectively, while in hypertensive patients, PALSpump ≤ 14.2% was found to be an independent differentiator for occurrence of AF or not with sensitivity of 81% and specificity of 84% (AUC = 0.838, P < 0.001). LAVI≥29.3 mL/m2 was an independent characteristic for reflecting different LA remodeling in lone AF or hypertension with AF. Conclusions The impairment of LA phasic functions was varied in patients with hypertension and/or AF. The disturbed LA phasic functions were proved to have independent abilities of differential diagnosis in this heterogeneous population associated with hypertension or AF.

2020 ◽  
Author(s):  
Arisara Kiatsilapanan ◽  
Sirilak Surachetpong

Abstract Background : Left atrial (LA) function plays an important role in diastolic dysfunction in cats with hypertrophic cardiomyopathy (HCM). Two-dimensional speckle tracking echocardiography (2D-STE) is a novel technique for assessing LA function. This study aimedto evaluate changes in the LA function inHCM cats compared to normal cats, using 2D-STE. Results: Seventeen client-owned cats affected with HCM and twenty healthy control cats. Conventional echocardiographic and 2D-STE variables were measured and compared between groups (the normal and HCM groups). The difference between two groups was compared by using the independent Student’s t-test. A p -value less than 0.05 was considered significant. Variability from the 2D-STE variables tests displayed good reproducibility (coefficient of variation ≤15%). The mean value of peak atrial longitudinal strain (PALS) in the HCM group (13.16 ± 8.64) was lower in the control group (28.54 ±10.31) ( p < 0.001). PALS was lowest at the LA roof region. The atrial longitudinal strain of septal and lateral regions was significantly lower in the HCM group than the normal group. PALS correlated with the percentage of the LA fractional shortening (LA-FS) (r=0.538, p =0.001), the percentage of the LA ejection fraction (LA-EF) (r =0.797, p <0.001), and the LA fractional area change (FAC) (r =0.746, p <0.001). Conclusions: PALS can be used to evaluate changes in theLA function in HCM cats. It is a reproducible method for assessing the LA function in cats affected with HCM. Keywords cats; heart; left atrium; strain


2020 ◽  
Author(s):  
Arisara Kiatsilapanan ◽  
Sirilak Surachetpong

Abstract Background : Left atrial (LA) function plays an important role in diastolic dysfunction in cats with hypertrophic cardiomyopathy (HCM). Two-dimensional speckle tracking echocardiography (2D-STE) is a novel technique for assessing LA function. This study aimedto evaluate changes in the LA function inHCM cats compared to normal cats, using 2D-STE. Results: Seventeen client-owned cats affected with HCM and twenty healthy control cats. Conventional echocardiographic and 2D-STE variables were measured and compared between groups (the normal and HCM groups). The difference between two groups was compared by using the independent Student’s t-test. A p -value less than 0.05 was considered significant. Variability from the 2D-STE variables tests displayed good reproducibility (coefficient of variation ≤15%). The mean value of peak atrial longitudinal strain (PALS) in the HCM group (13.16 ± 8.64) was lower in the control group (28.54 ±10.31) ( p < 0.001). PALS was lowest at the LA roof region. The atrial longitudinal strain of septal and lateral regions was significantly lower in the HCM group than the normal group. PALS correlated with the percentage of the LA fractional shortening (LA-FS) (r=0.538, p =0.001), the percentage of the LA ejection fraction (LA-EF) (r =0.797, p <0.001), and the LA fractional area change (FAC) (r =0.746, p <0.001). Conclusions: PALS can be used to evaluate changes in theLA function in HCM cats. It is a reproducible method for assessing the LA function in cats affected with HCM.


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