LEFT ATRIAL STRAIN BY SPECKLE TRACKING ECHOCARDIOGRAPHY IS NOT PREDICTED FUNCTIONAL CAPACITY IN HYPERTENSIVE POPULATION WITH PRESERVED SYSTOLIC FUNCTION AND NORMAL RESTING LEFT ATRIAL PRESSURE
Abstract
Abstract
Background: Hypertension is associated with diastolic dysfunction and impaired exercise capacity. LA has a substantial role to provides an optimal left ventricle diastolic filling. In this study, we aimed to assess the left atrial strain through STE as a predictor of functional capacity in the hypertensive population.
Methods: A total of 43 hypertensive women (mean age 50 ± 5.2 y.o; BMI 28.5± 4.1 Kg/m2) consecutively enrolled in this study. Patients with LVEF <50% or significant valvular pathology excluded. Two-dimensional STE performed to asses LA strain parameters, including PALS , PACS, and conduit strain. Functional capacity assessed by treadmill stress test using Bruce protocol.
Result: Mean PALS, PACS, and conduit strain in this study was lower than reference normal value 25.8%< 39%; 12.4% <17%; 13.5% <23%, respectively). All of the subjects had a preserved systolic function (mean LVEF 72.5 ± 7.6%) and normal resting LA pressure (mean PCWP 11.96 ± 2.09). Left atrial strain parameters value in the low-fair functional capacity group was not significantly different to average-good functional capacity group (p>0.05). Left atrial strain parameters value was not significantly correlated to exercise duration and achieved METS (P>0.05).
Conclusion: LA strain value in this study was below the standard reference limit. LA strain cannot predict functional capacity in the hypertensive population with preserved ejection fraction and normal resting LA pressure.
Downloads
References
2. von Roeder M, Rommel K-P, Kowallick JT, Blazek S, Besler C, Fengler K, Lotz J, Hasenfuß G, Lücke C, Gutberlet M, Schuler G, Schuster A, Lurz P. Influence of Left Atrial Function on Exercise Capacity and Left Ventricular Function in Patients With Heart Failure and Preserved Ejection Fraction. Circ Cardiovasc Imaging. 2017;10.
3. Blume GG, Mcleod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, Tsang TSM. Left atrial function: physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12:421–430.
4. Xu T-Y, Sun JP, Lee AP-W, Yang XS, Ji L, Zhang Z, Li Y, Yu C-M, Wang J-G. Left Atrial Function as Assessed by Speckle-Tracking Echocardiography in Hypertension. Medicine (Baltimore) [Internet]. 2015 [cited 2017 Oct 26];94. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602743/
5. American Society of Echocardiography. American Society of Echocardiography: Guideline Reference Book. 2005.
6. Nagueh SF, Middleton KJ, Kopelen HA, Zoghbi WA, Quiñones MA. Doppler tissue imaging: a noninvasive technique for evaluation of left ventricular relaxation and estimation of filling pressures. J Am Coll Cardiol. 1997;30:1527–1533.
7. Cameli M, Mandoli GE, Loiacono F, Dini FL, Henein M, Mondillo S. Left atrial strain: a new parameter for assessment of left ventricular filling pressure. Heart Fail Rev. 2016;21:65–76.
8. Cameli M, Caputo M, Mondillo S, Ballo P, Palmerini E, Lisi M, Marino E, Galderisi M. Feasibility and reference values of left atrial longitudinal strain imaging by two-dimensional speckle tracking. Cardiovasc Ultrasound. 2009;7:6.
9. Pathan F, D’Elia N, Nolan MT, Marwick TH, Negishi K. Normal Ranges of Left Atrial Strain by Speckle-Tracking Echocardiography: A Systematic Review and Meta-Analysis. J Am Soc Echocardiogr Off Publ Am Soc Echocardiogr. 2017;30:59-70.e8.
10. Cameli M, Lisi M, Righini FM, Benincasa S, Solari M, D’Ascenzi F, Focardi M, Lunghetti S, Mondillo S. Left atrial strain in patients with arterial hypertension. Int Cardiovasc Forum J. 2013;1:31–36.
11. Fontes-Carvalho R, Sampaio F, Teixeira M, Ruivo C, Ribeiro J, Azevedo A, Leite-Moreira A, Ribeiro VG. Left atrial deformation analysis by speckle tracking echocardiography to predict exercise capacity after myocardial infarction. Rev Port Cardiol Orgao Of Soc Port Cardiol Port J Cardiol Off J Port Soc Cardiol. 2018;37:821–830.
12. Kusunose K, Motoki H, Popovic ZB, Thomas JD, Klein AL, Marwick TH. Independent association of left atrial function with exercise capacity in patients with preserved ejection fraction. Heart Br Card Soc. 2012;98:1311–1317.
13. D’Andrea A, Caso P, Romano S, Scarafile R, Cuomo S, Salerno G, Riegler L, Limongelli G, Di Salvo G, Romano M, Liccardo B, Iengo R, Ascione L, Del Viscovo L, Calabrò P, Calabrò R. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: A two-dimensional speckle strain study. Int J Cardiol. 2009;132:354–363.
PDF downloads: 3049
Copyright (c) 2019 Indonesian Journal of Cardiology
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
