PMID- 33128641
OWN - NLM
STAT- MEDLINE
DCOM- 20210628
LR  - 20210628
IS  - 1875-8312 (Electronic)
IS  - 1569-5794 (Linking)
VI  - 37
IP  - 3
DP  - 2021 Mar
TI  - How to incorporate left atrial strain in the diagnostic algorithm of left 
      ventricular diastolic dysfunction.
PG  - 945-951
LID - 10.1007/s10554-020-02070-6 [doi]
AB  - The combination of early trans-mitral inflow and mitral annular tissue Doppler 
      velocities (E/e' ratio) is widely applied to noninvasively estimate left 
      ventricular (LV) filling pressures. However, when E/e' is between 8 and 14 its 
      accuracy decreases substantially. Left atrial (LA) deformation analysis by 
      speckle tracking echocardiography was recently proposed as an alternative 
      approach to estimate LV filling pressures, but its role when E/e' is between 8 
      and 14 has been under-investigated. We aimed to assess whether LA strain could 
      help to identify elevated filling pressures in patients with E/e' between 8 and 
      14. Among consecutive non-selected patients who underwent a comprehensive 
      echocardiographic evaluation, we enrolled those with E/e' ratio > 8 and </= 14. 
      Exclusion criteria were: organic mitral valve disease or mitral surgery; presence 
      of mitral regurgitation greater than moderate in severity; diseases associated 
      with pre-capillary pulmonary hypertension; and undetectable systolic pulmonary 
      artery pressure (PAP-S). Peak LA longitudinal (PALS) and contraction strain 
      (PACS) values was obtained by averaging all segments, and by separately averaging 
      segments measured in the 4-chamber and 2-chamber views. Seventy-six patients had 
      E/e' > 8 and </= 14 and formed the study cohort. Mean age 69 +/- 12 years, LV 
      ejection fraction (LVEF) 54.5 +/- 11.2%, mean E/e' 11.2 +/- 1.9, PAP-S 33 +/- 7 mmHg, 
      PALS 31.6 +/- 11.7%. PALS was significantly associated to PAP-S after adjustment 
      for LVEF, E/e', septal LV longitudinal shortening velocity (s'), LA volume 
      indexed (p = 0.002) and also for ASE/EACVI diastolic dysfunction classification 
      (p = 0.0002). Furthermore, PALS but not ASE/EACVI diastolic dysfunction grading, 
      resulted independently associated to New York Heart Association (NYHA) class 
      (p = 0.0004). PALS is able to predict increased intra-cardiac pressure and NYHA 
      class in patients characterized by E/e' between 8 and 14. Therefore, we propose 
      that PALS might be incorporated in a simplified diagnostic algorithm based on 
      E/e' classes.
FAU - Cerrito, L F
AU  - Cerrito LF
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Maffeis, C
AU  - Maffeis C
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Inciardi, R M
AU  - Inciardi RM
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Tafciu, E
AU  - Tafciu E
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Benfari, G
AU  - Benfari G
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Bergamini, C
AU  - Bergamini C
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Ribichini, F L
AU  - Ribichini FL
AD  - Section of Cardiology, University of Verona, Verona, Italy.
FAU - Rossi, A
AU  - Rossi A
AD  - Section of Cardiology, University of Verona, Verona, Italy. 
      andrea9rossi@gmail.com.
AD  - Echocardiographic Laboratory, Azienda Ospedaliera Universitaria Verona, P.le 
      Stefani 1, 37126, Verona, Italy. andrea9rossi@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20201031
PL  - United States
TA  - Int J Cardiovasc Imaging
JT  - The international journal of cardiovascular imaging
JID - 100969716
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - *Algorithms
MH  - Arterial Pressure
MH  - *Atrial Function, Left
MH  - *Decision Support Techniques
MH  - Diastole
MH  - *Echocardiography, Doppler
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Observer Variation
MH  - Predictive Value of Tests
MH  - Pulmonary Artery/diagnostic imaging/physiopathology
MH  - Reproducibility of Results
MH  - Stroke Volume
MH  - Ventricular Dysfunction, Left/*diagnostic imaging/physiopathology
MH  - *Ventricular Function, Left
OTO - NOTNLM
OT  - Diastolic function
OT  - Left atrial strain
OT  - Left ventricle
OT  - Speckle tracking echocardiography
EDAT- 2020/11/01 06:00
MHDA- 2021/06/29 06:00
CRDT- 2020/10/31 17:07
PHST- 2020/06/29 00:00 [received]
PHST- 2020/10/09 00:00 [accepted]
PHST- 2020/11/01 06:00 [pubmed]
PHST- 2021/06/29 06:00 [medline]
PHST- 2020/10/31 17:07 [entrez]
AID - 10.1007/s10554-020-02070-6 [pii]
AID - 10.1007/s10554-020-02070-6 [doi]
PST - ppublish
SO  - Int J Cardiovasc Imaging. 2021 Mar;37(3):945-951. doi: 
      10.1007/s10554-020-02070-6. Epub 2020 Oct 31.