Association between left atrial strain and left ventricular diastolic function in patients with acute coronary syndrome

Fernandes, Rafael Modesto; Le Bihan, David; Vilela, Andrea A; Barretto, Rodrigo B M; Santos, Elizabete S; Assef, Jorge E; Pedra, Simone Rolim Fontes; Sousa, Amanda G M R; Timerman, Ari

BACKGROUND:

Left ventricular diastolic function is an important prognostic marker in acute coronary syndrome. However, classifcation of the dysfunction grade using isolated echocardiographic parameters remains difcult. Therefore, it is necessary to combine multiple data in diagnostic algorithms. The purpose of this study was to evaluate the capacity of left atrial strain (LAS) components to classify left ventricular diastolic dysfunction (DD) grade.

METHODS:

Cross-sectional study with 109 consecutive patients admitted to the emergency room with acute coronary syndrome. Patients were referred for echocardiographic evaluation within 72 h. Mean values of LAS, corresponding to three phases of atrial function (reservoir, conduit and contraction), were obtained by speckle-tracking echocardiography. Patients were divided according to the diastolic dysfunction grade for later association with the LAS.

RESULTS:

The three LAS components showed moderate correlation with most diastolic variables (left atrial volume index, E/e' ratio and e' wave). In addition, there was related reduction of the LAS, which was inversely proportional to the DD grade (p< 0.05). LAS was efective for the identifcation of patients with DD grade III [area under the curve (AUC) for the reservoir=0.99; conduit AUC=0.89; contraction AUC=0.99) and also those with DD grade II or III (reservoir AUC=0.94; conduit AUC=0.92; contraction AUC=0.80].

CONCLUSIONS:

LAS alone presented excellent capacity to classify DD in patients with acute coronary syndrome and may represent an additional tool for this purpose.

Secretaria de Estado da Saúde - BVS

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