Left atrial contractile longitudinal strain determines intrinsic left atrial function regardless of load status and left ventricular deformation
Purpose Left atrial (LA) longitudinal strain (S) has been proposed as a superior, non-invasive parameter over LA volumetric assessment. LAS has diagnostic and prognostic value in many cardiovascular pathologies. Nevertheless, the acute effect of hemodynamic changes on LAS indices is not well-established. We sought to identify volume independent physiomechanical changes in LA and interrelation between LA and left ventricular (LV) strain indices following a large amount of fluid loss provided by hemodialysis. Methods Seventy-five patients between 18 and 85 years of age under hemodialysis therapy were included. The echocardiographic images were obtained before and after hemodialysis. Phasic LAS and LV global longitudinal strain (GLS) were calculated. The impact of volume depletion on echocardiographic measurements and their temporal correlation were calculated. Results LV and LA dimensions,volumes and LV, LA reservoir, and conduit deformation showed a significant decrease after hemodialysis. No significant change was observed for $ LAS_{contraction} $ (p = 0.203). The ultrafiltrated volume was significantly correlated with the changes in LVGLS (r = 0.75, p < 0.001), and $ LAS_{reservoir} $ (r = 0.81, p < 0.001) and LA total emptying volume (r = 0.80, p < 0.001). Absolute changes in $ LAS_{reservoir} $ and LVGLS were strongly correlated (r = 0.83, p < 0.001). There was no correlation between absolute changes in $ LAS_{contraction} $ and LVGLS or ultrafiltrated volume (p = NS, both). Conclusion LA reservoir and conduit LS are highly volume dependent strain parameters and are strongly correlated with LV deformation along with ultrafiltrated volume. Acute excessive volume depletion or LV deformation have no influence on $ LAS_{contraction} $. It is important to identify independent easily accessible functional parameters for the LA which would improve clinical evaluation..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
The international journal of cardiovascular imaging - 37(2021), 11 vom: 27. Juni, Seite 3245-3253 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ünlü, Serkan [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| BKL: | |
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| Themen: |
| Anmerkungen: |
© The Author(s), under exclusive licence to Springer Nature B.V. 2021 |
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| doi: |
10.1007/s10554-021-02324-x |
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SPR045440891 |
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| 520 | |a Purpose Left atrial (LA) longitudinal strain (S) has been proposed as a superior, non-invasive parameter over LA volumetric assessment. LAS has diagnostic and prognostic value in many cardiovascular pathologies. Nevertheless, the acute effect of hemodynamic changes on LAS indices is not well-established. We sought to identify volume independent physiomechanical changes in LA and interrelation between LA and left ventricular (LV) strain indices following a large amount of fluid loss provided by hemodialysis. Methods Seventy-five patients between 18 and 85 years of age under hemodialysis therapy were included. The echocardiographic images were obtained before and after hemodialysis. Phasic LAS and LV global longitudinal strain (GLS) were calculated. The impact of volume depletion on echocardiographic measurements and their temporal correlation were calculated. Results LV and LA dimensions,volumes and LV, LA reservoir, and conduit deformation showed a significant decrease after hemodialysis. No significant change was observed for $ LAS_{contraction} $ (p = 0.203). The ultrafiltrated volume was significantly correlated with the changes in LVGLS (r = 0.75, p < 0.001), and $ LAS_{reservoir} $ (r = 0.81, p < 0.001) and LA total emptying volume (r = 0.80, p < 0.001). Absolute changes in $ LAS_{reservoir} $ and LVGLS were strongly correlated (r = 0.83, p < 0.001). There was no correlation between absolute changes in $ LAS_{contraction} $ and LVGLS or ultrafiltrated volume (p = NS, both). Conclusion LA reservoir and conduit LS are highly volume dependent strain parameters and are strongly correlated with LV deformation along with ultrafiltrated volume. Acute excessive volume depletion or LV deformation have no influence on $ LAS_{contraction} $. It is important to identify independent easily accessible functional parameters for the LA which would improve clinical evaluation. | ||
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