Left Atrial Strain for assessment of left ventricle diastolic dysfunction in acute coronary syndrome patients.
Tunis Med
; 102(7): 399-405, 2024 Jul 05.
Article
em En
| MEDLINE
| ID: mdl-38982963
ABSTRACT
INTRODUCTION:
Patients with acute coronary syndrome (ACS) have a high incidence of Left ventricle diastolic dysfunction (DD). Latest algorithms for the assessment of DD lay on 2D parameters and describe a grading to quantify its severity. However, there persists a "gray zone" of values in which DD remains indeterminate.AIM:
to analyze the diagnostic value of Left atrium strain (LAS) for categorization of LV DD and assessment of LV filling pressures in ACS patients.METHODS:
Cross-sectional study that prospectively evaluated 105 patients presenting ACS with preserved LV ejection fraction (LVEF). Patients were divided in 4 groups according to the DD grade. Mean values of LAS, corresponding to three phases of atrial function reservoir (LASr), conduit (LAScd) and contraction (LASct), were obtained by speckle-tracking echocardiography.RESULTS:
Mean age was 60±10 years, with a gender ratio of 6.14. LASr and LASct were significantly lower according to DD severity (p combined=0.021, p combined=0.034; respectively). E/e' ratio was negatively correlated to LASr (r= - 0.251; p= 0.022) and LASct (r= -0.197; p=0.077). Left atrial volume index (LAVI) was also negatively correlated to LASr (r= -0.294, p= 0.006) and LASct (r= -0.3049, p=0.005). Peak tricuspid regurgitation was negatively correlated to LASr (r=-0.323, p=0.017) and LASct (r=-0.319, p=0.020). Patients presenting elevated LV filling pressures had lower LASr and LASct (p=0.049, p=0.022, respectively) compared to patients witn normal LV filling pressures. ROC curve analysis showed that a LASr < 22% (Se= 75%, Sp= 73%) and a LASct < 13% (Se= 71%, Sp=58%) can increase the likelihood of DD grade II or III by 4.6 (OR= 4.6; 95% CI 1.31-16.2; p=0.016) and 3.7 (OR= 3.7; 95% CI 1.06-13.1; p= 0.047), respectively.CONCLUSION:
LAS is a valuable tool, which can be used to categorize DD in ACS patients.Palavras-chave
Texto completo:
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ecocardiografia
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Disfunção Ventricular Esquerda
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Síndrome Coronariana Aguda
Limite:
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Tunis Med
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Tunísia
País de publicação:
Tunísia