Early detection of cardiac alterations by left atrial strain in patients with risk for cardiac abnormalities with preserved left ventricular systolic and diastolic function

被引:0
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作者
Kerstin Braunauer
Elisabeth Pieske-Kraigher
Evgeny Belyavskiy
Radhakrishnan Aravind-Kumar
Martin Kropf
Robin Kraft
Athanasios Frydas
Esteban Marquez
Engin Osmanoglou
Carsten Tschöpe
Frank Edelmann
Burkert Pieske
Hans-Dirk Düngen
Daniel A. Morris
机构
[1] Charité – Universitätsmedizin Berlin,Department of Internal Medicine and Cardiology
[2] German Center for Cardiovascular Research (DZHK),Department of Internal Medicine and Cardiology
[3] Private Clinic of Radiology (Q-Diagnostica – Scanner Murcia),Department of Internal Medicine and Cardiology
[4] Meoclinic,undefined
[5] Berlin Institute of Health (BIH),undefined
[6] German Heart Institute,undefined
来源
The International Journal of Cardiovascular Imaging | 2018年 / 34卷
关键词
Speckle-tracking; Echocardiography; Left atrial; Strain;
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学科分类号
摘要
This study sought to examine whether early cardiac alterations could be detected by left atrial (LA) strain in patients with risk for cardiac abnormalities. In this cross-sectional and retrospective study, we included patients with (n = 234) and without (n = 48) risk for cardiac abnormalities (i.e. those with arterial hypertension, diabetes mellitus and/or a history of coronary artery disease) of similar age and with preserved left ventricular (LV) systolic and diastolic function according to standard criteria. LA strain was significantly altered in patients with risk for cardiac abnormalities in comparison to those without risk (29.2 ± 8.6 vs. 38.5 ± 12.6%; rate of impaired LA strain: 18.8% vs. 0%; all p < 0.01) and was the most sensitive parameter to detect early LA alterations in comparison with other LA functional parameters (rate of impaired LA strain rate, LA total emptying fraction, and LA expansion index 3.8%, 7.3%, and 3.8%, respectively). Moreover, in patients with risk for cardiac abnormalities LA strain was altered even in the absence of subtle LV systolic and diastolic alterations (rates 13.9% and 6.8%), albeit to a lesser extent than in patients with an abnormal LV longitudinal systolic strain or abnormal mitral annular e′ velocities (rates 48.5% and 24.4%). Regarding the clinical relevance of these findings, an impaired LA strain (i.e. < 23%) was significantly linked to exertional dyspnea (OR 3.5 [1.7–7.0]) even adjusting the analyses by age, gender and subtle LV abnormalities. In conclusion, the findings from this study suggest that LA strain measurements could be useful to detect early cardiac alterations in patients with risk for cardiac abnormalities with preserved LV systolic and diastolic function and that these early LA strain alterations could be linked to exertional dyspnea.
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页码:701 / 711
页数:10
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