PMID- 36891246 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230310 IS - 2297-055X (Print) IS - 2297-055X (Electronic) IS - 2297-055X (Linking) VI - 10 DP - 2023 TI - Phasic left atrial strain to predict worsening of diastolic function: Results from the prospective Berlin Female Risk Evaluation follow-up trial. PG - 1070450 LID - 10.3389/fcvm.2023.1070450 [doi] LID - 1070450 AB - PURPOSE: The predictive value of maximum left atrial volume index (LAVI), phasic left atrial strain (LAS) and other standard echocardiographic parameters assessing left ventricular (LV) diastolic function to discriminate a future worsening of diastolic function (DD) in patients at risk is unclear. We aimed to prospectively assess and compare the clinical impact of these parameters in a randomly selected study sample of the general urban female population. METHODS AND RESULTS: A comprehensive clinical and echocardiographic evaluation was performed in 256 participants of the Berlin Female Risk Evaluation (BEFRI) trial after a mean follow up time of 6.8 years. After an assessment of participants' current DD status, the predictive impact of an impaired LAS on the course of DD was assessed and compared with LAVI and other DD parameters using receiver operating characteristic (ROC) curve and multivariate logistic regression analyses. Subjects with no DD (DD0) who showed a decline of diastolic function by the time of follow-up showed a reduced LA reservoir (LASr) and conduit strain (LAScd) compared to subjects who remained in the healthy range (LASr 28.0% +/- 7.0 vs. 41.9% +/- 8.5; LAScd -13.2% +/- 5.1 vs. -25.4% +/- 9.1; p < 0.001). With an area under the curve (AUC) of 0.88 (95%CI 0.82-0.94) and 0.84 (95%CI 0.79-0.89), LASr and LAScd exhibited the highest discriminative value in predicting worsening of diastolic function, whereas LAVI was only of limited prognostic value [AUC 0.63 (95%CI 0.54-0.73)]. In logistic regression analyses, LAS remained a significant predictor for a decline of diastolic function after controlling for clinical and standard echocardiographic DD parameters, indicating its incremental predictive value. CONCLUSION: The analysis of phasic LAS may be useful to predict worsening of LV diastolic function in DD0 patients at risk for a future DD development.GRAPHICAL ABSTRACT. CI - Copyright (c) 2023 Brand, Romero Dorta, Wolf, Blaschke-Waluga, Seeland, Crayen, Bischoff, Mattig, Dreger, Stangl, Regitz-Zagrosek, Landmesser, Knebel and Stangl. FAU - Brand, Anna AU - Brand A AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. AD - Department of Cardiology, Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. FAU - Romero Dorta, Elena AU - Romero Dorta E AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Wolf, Adrian AU - Wolf A AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Blaschke-Waluga, Daniela AU - Blaschke-Waluga D AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Seeland, Ute AU - Seeland U AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. AD - Institute of Social Medicine, Epidemiology and Health Economics, Charite - Universitatsmedizin Berlin, Berlin, Germany. FAU - Crayen, Claudia AU - Crayen C AD - Department of Education and Psychology, Freie Universitat Berlin, Berlin, Germany. FAU - Bischoff, Sven AU - Bischoff S AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Mattig, Isabel AU - Mattig I AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. FAU - Dreger, Henryk AU - Dreger H AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. FAU - Stangl, Karl AU - Stangl K AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. FAU - Regitz-Zagrosek, Vera AU - Regitz-Zagrosek V AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. AD - Institute of Gender in Medicine, Charite - Universitatsmedizin Berlin, Berlin, Germany. AD - University Hospital Zurich, University of Zurich, Zurich, Switzerland. FAU - Landmesser, Ulf AU - Landmesser U AD - Department of Cardiology, Charite - Universitatsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. FAU - Knebel, Fabian AU - Knebel F AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. AD - Clinical Department of Cardiology, Internal Medicine II, Sana Klinikum Lichtenberg, Berlin, Germany. FAU - Stangl, Verena AU - Stangl V AD - Department of Cardiology and Angiology, Charite - Universitatsmedizin Berlin, Campus Mitte, Berlin, Germany. AD - DZHK (German Centre for Cardiovascular Research), Partner site Berlin, Berlin, Germany. LA - eng PT - Journal Article DEP - 20230220 PL - Switzerland TA - Front Cardiovasc Med JT - Frontiers in cardiovascular medicine JID - 101653388 PMC - PMC9986257 OTO - NOTNLM OT - BEFRI OT - LAVI OT - diastolic dysfunction OT - left atrial strain OT - left atrium COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2023/03/10 06:00 MHDA- 2023/03/10 06:01 PMCR- 2023/01/01 CRDT- 2023/03/09 02:11 PHST- 2022/10/14 00:00 [received] PHST- 2023/02/02 00:00 [accepted] PHST- 2023/03/09 02:11 [entrez] PHST- 2023/03/10 06:00 [pubmed] PHST- 2023/03/10 06:01 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.3389/fcvm.2023.1070450 [doi] PST - epublish SO - Front Cardiovasc Med. 2023 Feb 20;10:1070450. doi: 10.3389/fcvm.2023.1070450. eCollection 2023.