RESUMEN
BACKGROUND: Left atrial peak systolic strain (LA-PSS) imaging is an emerging index of LA function, and it was shown to be decreased in heart failure with preserved ejection fraction. We aimed to determine whether LA-PSS could be used as an additional diagnostic parameter to current existing guidelines for the presence of left ventricle diastolic dysfunction (LVDD). MATERIALS AND METHODS: A total of 190 consecutive adult patients with cardiovascular risk factors and normal LV ejection fraction with no prior history of heart failure were included in the study. Speckle tracking software was used to study ventricular parietal deformity, left ventricle global longitudinal systolic strain (LV-GLS), and LA-PSS. RESULTS: The median LV-GLS was -19%, with a significant difference (p<0.001) between patients with normal diastolic function vs those with LVDD. The median LA-PSS was 33% (30 to 38%) (p<0.001). Most patients (61%) had grade 1 atrial dysfunction based on PSS (range 24% to 35%). The analysis of the area under the ROC curve of the LA-PSS as a potential indicator pathway of LVDD was 67% (95% CI 62-72), and 75% (95% CI 70-80), when the indeterminate pattern was included. The decreased LA-PSS made it possible to reclassify patients with an indeterminate pattern of diastolic function in 96% of cases. CONCLUSION: These results support the potential role of LA-PSS as an additional parameter for the diagnosis of LVDD in patients with normal ejection fraction, and may be integrated into the guidelines for routine evaluation of patients.
RESUMEN
BACKGROUND: There is a global tendency to emphasize the prevention and early diagnosis of diseases that have a great impact on public health. Atrial fibrillation (AF) has a prevalence affecting 1.5-2% of the general population. Certain variables of the P wave allow us to identify and stratify patients at risk of developing AF. MATERIALS AND METHODS: This is an observational, descriptive, and longitudinal study to determine the applicability of the electrocardiographic (ECG) morphology, voltage, and P wave duration (MVP) risk score to predict the development of AF in consecutive patients with systemic hypertension (SH) in an initial follow-up of 12 months. RESULTS: Initially, 104 patients were included, of whom 12 died during follow-up and 17 did not attend subsequent checkups during the COVID-19 pandemic; therefore, they were excluded. The study patients were 75, of whom AF was detected in 25 patients (33%). The average duration of the P wave was 120 ± 26 ms, the average voltage was 0.1 ± 0.5 Mv. The high-risk MVP ECG score had an [area under the curve, 0.69; 95% confidence intervals (CI), 0.59-0.79] and demonstrated a specificity and a positive predictive value of 100%, a negative predictive value of 76%, and a sensitivity of 40% for predicting the development of AF. CONCLUSIONS: The present study establishes for the first time that SH patients who possess a high-risk MVP ECG score have a significantly higher incidence of developing AF. The high-risk MVP Score has a specificity and a positive predictive value of 100% and a high negative predictive value with a moderate sensitivity for the prediction of the development of AF in SH patients.
