Improving the Assessment of Left Ventricular Diastolic Dysfunction by Including Left Atrial Strain in the Algorithm

IF 6.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Failure Pub Date : 2025-06-01 DOI:10.1016/j.cardfail.2024.08.064

LIN WANG MD, MS , JONATHAN WEBER MPH , JASON CRAFT MD , MICHAEL PASSICK RCDS, MBA , OMAR K. KHALIQUE MD , ZIAD A. ALI MD, DPhil , JAE K. OH MD , J. JANE CAO MD, MPH

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引用次数: 0

Abstract

Background

The latest guidelines on echocardiographic assessment of left ventricular diastolic dysfunction (LVDD) leave a significant proportion of patients with LVDD status undetermined. We aimed to examine the implication of an alternative algorithm incorporating left atrial (LA) strain as a tiebreaker on the indeterminate LVDD category.

Methods and Results

We included 823 patients who underwent echocardiography and cardiac magnetic resonance within 7 days. LVDD was assessed by echocardiography following contemporary guidelines and an alternative algorithm including LA reservoir strain as a tie breaker. LVDD was examined for its association with LV myocardial scar burden by cardiac magnetic resonance, and a composite outcome. There were 275 patients (33%) who had LVDD, of whom 119 had advanced grades of LVDD (grades II–III), and 117 (14%) had an indeterminate LVDD grade. When LA strain was applied at cutpoints of 18%, 24%, and 35%, patients were reclassified as normal or LVDD-dependent accordingly. Reclassification allowed a similar outcome risk stratification as the current guidelines.

Conclusions

LA reservoir strain improved LVDD assessment by eliminating indeterminate status/grade while maintaining the same effective outcome stratification as the current guidelines.

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将左心房应变纳入算法，改进左心室舒张功能障碍的评估：LA 应变和左心室舒张功能障碍评估。

背景：最新的左心室舒张功能障碍（LVDD）超声心动图评估指南使相当一部分患者的 LVDD 状态未确定。我们旨在研究将左心房（LA）应变作为不确定 LVDD 类别的决定因素的替代算法的影响：我们纳入了 823 名在 7 天内接受超声心动图和心脏磁共振成像检查的患者。超声心动图评估 LVDD 时遵循了当代指南和一种替代算法，其中包括将 LA 储层应变作为平局判定标准。通过心脏磁共振成像检查 LVDD 与左心室心肌瘢痕负担的关系，并得出综合结果。275例（33%）患者患有LVDD，其中119例为晚期LVDD（II-III级），117例（14%）LVDD等级不确定。当 LA 应变的切点为 18%、24% 和 35% 时，受试者会相应地被重新分类为正常或依赖 LVDD。重新分类后的结果风险分级与现行指南相似：结论：LA 储库应变通过消除不确定状态/等级，改善了 LVDD 评估，同时保持了与现行指南相同的有效结果分层。

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

Journal of Cardiac Failure 医学-心血管系统

CiteScore

7.80

自引率

8.30%

发文量

653

审稿时长

21 days

期刊介绍： Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.