Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure

Athanasios Frydas; Daniel A. Morris; Evgeny Belyavskiy; Aravind Kumar Radhakrishnan; Martin Kropf; Marijana Tadic; Lothar Roessig; Carolyn S.P. Lam; Sanjiv J. Shah; Scott D. Solomon; Burkert Pieske; Elisabeth Pieske-Kraigher

doi:10.1002/ehf2.12820

Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure

Athanasios Frydas^*, Daniel A. Morris, Evgeny Belyavskiy, Aravind Kumar Radhakrishnan, Martin Kropf, Marijana Tadic, Lothar Roessig, Carolyn S.P. Lam, Sanjiv J. Shah, Scott D. Solomon, Burkert Pieske, Elisabeth Pieske-Kraigher^*

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

72 Scopus citations

Abstract

Aims: The purpose of this retrospective analysis was to examine the association of left atrial (LA) strain (i.e. LA reservoir function) with left ventricular diastolic dysfunction (DD) in patients with heart failure with reduced and preserved left ventricular ejection fraction (LVEF). Methods and results: We analysed the baseline echocardiographic recordings of 300 patients in sinus rhythm from the SOCRATES-PRESERVED and SOCRATES-REDUCED studies. LA volume index was normal in 89 (29.7%), of whom 60.6% had an abnormal LA reservoir strain (i.e. ≤23%). In addition, the extent of LA strain impairment was significantly associated with the severity of DD according to the 2016 American Society of Echocardiography recommendations (DD grade I: LA strain 22.2 ± 6.6, rate of abnormal LA strain 62.9%; DD grade II: LA strain 16.6 ± 7.4, rate of abnormal LA strain 88.6%; DD grade III: LA strain 11.1 ± 5.4%, rate of abnormal LA strain 95.7%; all P < 0.01). In line with these findings, LA strain had a good diagnostic performance to determine severe DD [area under the curve 0.83 (95% CI 0.77–0.88), cut-off 14.1%, sensitivity 80%, specificity 77.8%], which was significantly better than for LA volume index, LA total emptying fraction, and the mitral E/e′ ratio. Conclusions: The findings of this analysis suggest that LA strain could be a useful parameter in the evaluation of DD in patients with heart failure and sinus rhythm, irrespective of LVEF.

Original language	English (US)
Pages (from-to)	1956-1965
Number of pages	10
Journal	ESC Heart Failure
Volume	7
Issue number	4
DOIs	https://doi.org/10.1002/ehf2.12820
State	Published - Aug 1 2020

Funding

This post hoc analysis of the SOCRATES-PRESERVED and SOCRATES-REDUCED studies was supported by Bayer Pharma AG, Berlin, and Merck Sharp & Dohme, a subsidiary of Merck & Co, Inc., Kenilworth, New Jersey. The authors would like to thank the staff of the Academic Echocardiography Laboratory of Charité University Medicine Berlin and all the patients for their participation in this study.

Keywords

Echocardiography
Left atrium
Speckle-tracking
Strain

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/ehf2.12820

Cite this

@article{8d4384af792a49b7ba5c0b3e3e53ee4c,

title = "Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure",

abstract = "Aims: The purpose of this retrospective analysis was to examine the association of left atrial (LA) strain (i.e. LA reservoir function) with left ventricular diastolic dysfunction (DD) in patients with heart failure with reduced and preserved left ventricular ejection fraction (LVEF). Methods and results: We analysed the baseline echocardiographic recordings of 300 patients in sinus rhythm from the SOCRATES-PRESERVED and SOCRATES-REDUCED studies. LA volume index was normal in 89 (29.7%), of whom 60.6% had an abnormal LA reservoir strain (i.e. ≤23%). In addition, the extent of LA strain impairment was significantly associated with the severity of DD according to the 2016 American Society of Echocardiography recommendations (DD grade I: LA strain 22.2 ± 6.6, rate of abnormal LA strain 62.9%; DD grade II: LA strain 16.6 ± 7.4, rate of abnormal LA strain 88.6%; DD grade III: LA strain 11.1 ± 5.4%, rate of abnormal LA strain 95.7%; all P < 0.01). In line with these findings, LA strain had a good diagnostic performance to determine severe DD [area under the curve 0.83 (95% CI 0.77–0.88), cut-off 14.1%, sensitivity 80%, specificity 77.8%], which was significantly better than for LA volume index, LA total emptying fraction, and the mitral E/e′ ratio. Conclusions: The findings of this analysis suggest that LA strain could be a useful parameter in the evaluation of DD in patients with heart failure and sinus rhythm, irrespective of LVEF.",

keywords = "Echocardiography, Left atrium, Speckle-tracking, Strain",

author = "Athanasios Frydas and Morris, {Daniel A.} and Evgeny Belyavskiy and Radhakrishnan, {Aravind Kumar} and Martin Kropf and Marijana Tadic and Lothar Roessig and Lam, {Carolyn S.P.} and Shah, {Sanjiv J.} and Solomon, {Scott D.} and Burkert Pieske and Elisabeth Pieske-Kraigher",

note = "Publisher Copyright: {\textcopyright} 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology",

year = "2020",

month = aug,

day = "1",

doi = "10.1002/ehf2.12820",

language = "English (US)",

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T1 - Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure

AU - Frydas, Athanasios

AU - Morris, Daniel A.

AU - Belyavskiy, Evgeny

AU - Radhakrishnan, Aravind Kumar

AU - Kropf, Martin

AU - Tadic, Marijana

AU - Roessig, Lothar

AU - Lam, Carolyn S.P.

AU - Shah, Sanjiv J.

AU - Solomon, Scott D.

AU - Pieske, Burkert

AU - Pieske-Kraigher, Elisabeth

PY - 2020/8/1

Y1 - 2020/8/1

N2 - Aims: The purpose of this retrospective analysis was to examine the association of left atrial (LA) strain (i.e. LA reservoir function) with left ventricular diastolic dysfunction (DD) in patients with heart failure with reduced and preserved left ventricular ejection fraction (LVEF). Methods and results: We analysed the baseline echocardiographic recordings of 300 patients in sinus rhythm from the SOCRATES-PRESERVED and SOCRATES-REDUCED studies. LA volume index was normal in 89 (29.7%), of whom 60.6% had an abnormal LA reservoir strain (i.e. ≤23%). In addition, the extent of LA strain impairment was significantly associated with the severity of DD according to the 2016 American Society of Echocardiography recommendations (DD grade I: LA strain 22.2 ± 6.6, rate of abnormal LA strain 62.9%; DD grade II: LA strain 16.6 ± 7.4, rate of abnormal LA strain 88.6%; DD grade III: LA strain 11.1 ± 5.4%, rate of abnormal LA strain 95.7%; all P < 0.01). In line with these findings, LA strain had a good diagnostic performance to determine severe DD [area under the curve 0.83 (95% CI 0.77–0.88), cut-off 14.1%, sensitivity 80%, specificity 77.8%], which was significantly better than for LA volume index, LA total emptying fraction, and the mitral E/e′ ratio. Conclusions: The findings of this analysis suggest that LA strain could be a useful parameter in the evaluation of DD in patients with heart failure and sinus rhythm, irrespective of LVEF.

AB - Aims: The purpose of this retrospective analysis was to examine the association of left atrial (LA) strain (i.e. LA reservoir function) with left ventricular diastolic dysfunction (DD) in patients with heart failure with reduced and preserved left ventricular ejection fraction (LVEF). Methods and results: We analysed the baseline echocardiographic recordings of 300 patients in sinus rhythm from the SOCRATES-PRESERVED and SOCRATES-REDUCED studies. LA volume index was normal in 89 (29.7%), of whom 60.6% had an abnormal LA reservoir strain (i.e. ≤23%). In addition, the extent of LA strain impairment was significantly associated with the severity of DD according to the 2016 American Society of Echocardiography recommendations (DD grade I: LA strain 22.2 ± 6.6, rate of abnormal LA strain 62.9%; DD grade II: LA strain 16.6 ± 7.4, rate of abnormal LA strain 88.6%; DD grade III: LA strain 11.1 ± 5.4%, rate of abnormal LA strain 95.7%; all P < 0.01). In line with these findings, LA strain had a good diagnostic performance to determine severe DD [area under the curve 0.83 (95% CI 0.77–0.88), cut-off 14.1%, sensitivity 80%, specificity 77.8%], which was significantly better than for LA volume index, LA total emptying fraction, and the mitral E/e′ ratio. Conclusions: The findings of this analysis suggest that LA strain could be a useful parameter in the evaluation of DD in patients with heart failure and sinus rhythm, irrespective of LVEF.

KW - Echocardiography

KW - Left atrium

KW - Speckle-tracking

KW - Strain

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U2 - 10.1002/ehf2.12820

DO - 10.1002/ehf2.12820

M3 - Article

C2 - 32613770

AN - SCOPUS:85087304796

SN - 2055-5822

VL - 7

SP - 1956

EP - 1965

JO - ESC Heart Failure

JF - ESC Heart Failure

IS - 4

ER -

Left atrial strain as sensitive marker of left ventricular diastolic dysfunction in heart failure

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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