Left Atrial Strain for assessment of left ventricle diastolic dysfunction in acute coronary syndrome patients.

Q3 Medicine
Saoussen Antit, Marwa Abdelhedi, Ridha Fekih, Khalil Bahri, Elhem Boussabah, Lilia Zakhama
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引用次数: 0

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.

左心房应变用于评估急性冠状动脉综合征患者的左心室舒张功能障碍。
简介急性冠状动脉综合征(ACS)患者的左心室舒张功能障碍(DD)发生率很高。最新的 DD 评估算法基于二维参数,并描述了量化 DD 严重程度的分级。目的:分析左心房应变(LAS)对 ACS 患者左心室舒张功能障碍分类和左心室充盈压评估的诊断价值:横断面研究:前瞻性评估了105例左心室射血分数(LVEF)保留的ACS患者。根据 DD 等级将患者分为 4 组。通过斑点追踪超声心动图获得与心房功能三个阶段相对应的 LAS 平均值:蓄积期(LASr)、导管期(LAScd)和收缩期(LASct):平均年龄(60±10)岁,性别比例为 6.14。DD严重程度不同,LASr和LASct明显降低(分别为p合=0.021和p合=0.034)。E/e'比值与 LASr(r= - 0.251;p= 0.022)和 LASct(r= -0.197;p=0.077)呈负相关。左心房容积指数(LAVI)也与 LASr(r= -0.294,p= 0.006)和 LASct(r= -0.3049,p=0.005)呈负相关。三尖瓣反流峰值与 LASr(r=-0.323,p=0.017)和 LASct(r=-0.319,p=0.020)呈负相关。与左心室充盈压正常的患者相比,左心室充盈压升高的患者的 LASr 和 LASct 更低(分别为 p=0.049 和 p=0.022)。ROC曲线分析显示,LASr<22%(Se=75%,Sp=73%)和LASct<13%(Se=71%,Sp=58%)可使DDⅡ级或Ⅲ级的可能性分别增加4.6(OR=4.6;95% CI:1.31-16.2;p=0.016)和3.7(OR=3.7;95% CI:1.06-13.1;p=0.047):LAS是一种有价值的工具,可用于对ACS患者的DD进行分类。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Tunisie Medicale
Tunisie Medicale Medicine-Medicine (all)
CiteScore
1.00
自引率
0.00%
发文量
72
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