当前位置: X-MOL 学术JACC Cardiovasc. Imaging › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Potential Usefulness and Clinical Relevance of Adding Left Atrial Strain to Left Atrial Volume Index in the Detection of Left Ventricular Diastolic Dysfunction
JACC: Cardiovascular Imaging ( IF 14.0 ) Pub Date : 2018-10-01 , DOI: 10.1016/j.jcmg.2017.07.029
Daniel A Morris 1 , Evgeny Belyavskiy 1 , Radhakrishnan Aravind-Kumar 1 , Martin Kropf 1 , Athanasios Frydas 2 , Kerstin Braunauer 1 , Esteban Marquez 3 , Maximilian Krisper 1 , Ruhdja Lindhorst 1 , Engin Osmanoglou 4 , Leif-Hendrik Boldt 1 , Florian Blaschke 1 , Wilhelm Haverkamp 1 , Carsten Tschöpe 2 , Frank Edelmann 5 , Burkert Pieske 6 , Elisabeth Pieske-Kraigher 1
Affiliation  

Objectives The purpose of this study was to analyze the potential usefulness and clinical relevance of adding left atrial (LA) strain to left atrial volume index (LAVI) in the detection of left ventricular diastolic dysfunction (LVDD) in patients with preserved left ventricular ejection fraction (LVEF).

Background Recent studies have suggested that LA strain could be of use in the evaluation of LVDD. However, the potential utility and clinical significance of adding LA strain to LAVI in the detection of LVDD remains uncertain.

Methods Using 2-dimensional speckle-tracking echocardiography, we analyzed a population of 517 patients in sinus rhythm at risk for LVDD such as those with arterial hypertension, diabetes mellitus, or history of coronary artery disease and preserved LVEF.

Results In patients with LV diastolic alterations and estimated elevated LV filling pressures, the rate of abnormal LA strain was significantly higher than an abnormal LAVI (62.4% vs. 33.6%, p < 0.01). In line with this, in patients with normal LAVI, high rates of LV diastolic alterations and abnormal LA strain were present (rates 80% and 29.4%, respectively). In agreement with these findings, adding LA strain to LAVI in the current evaluation of LVDD increased significantly the rate of detection of LVDD (relative and absolute increase 73.3% and 9.9%; rate of detection of LVDD: from 13.5% to 23.4%; p < 0.01). Regarding the clinical relevance of these findings, an abnormal LA strain (i.e., <23%) was significantly associated with worse New York Heart Association functional class, even when LAVI was normal. Moreover, in a retrospective post hoc analysis an abnormal LA strain had a significant association with the risk of heart failure hospitalization at 2 years (odds ratio: 6.6 [95% confidence interval: 2.6 to 16.6]) even adjusting this analysis for age and sex and in patients with normal LAVI.

Conclusions The findings from this study provide important insights regarding the potential usefulness and clinical relevance of adding LA strain to LAVI in the detection of LVDD in patients with preserved LVEF.



中文翻译:

将左心房应变添加到左心房容积指数在检测左心室舒张功能障碍中的潜在用途和临床相关性

目的本研究的目的是分析将左心房 (LA) 应变添加到左心房容积指数 (LAVI) 中检测左心室射血分数保留患者的左心室舒张功能不全 (LVDD) 的潜在用途和临床相关性(左心室射血分数)。

背景最近的研究表明 LA 菌株可用于评估 LVDD。然而,在 LAVI 中添加 LA 菌株在 LVDD 检测中的潜在效用和临床意义仍不确定。

方法使用二维斑点追踪超声心动图,我们分析了 517 名有 LVDD 风险的窦性心律患者,例如患有高血压、糖尿病或有冠状动脉疾病史且 LVEF 保留的患者。

结果在左室舒张期改变且估计左室充盈压升高的患者中,异常 LA 应变的发生率显着高于异常 LAVI(62.4% vs. 33.6%,p < 0.01)。与此相一致的是,在 LAVI 正常的患者中,左心室舒张期改变和 LA 应变异常的发生率较高(分别为 80% 和 29.4%)。与这些发现一致,在当前的 LVDD 评估中,在 LAVI 中添加 LA 菌株显着增加了 LVDD 的检出率(相对和绝对增加 73.3% 和 9.9%;LVDD 检出率:从 13.5% 增加到 23.4%;p < 0.01)。关于这些发现的临床相关性,即使 LAVI 正常,异常的 LA 菌株(即 <23%)与较差的纽约心脏协会功能分级显着相关。此外,在一项回顾性事后分析中,异常的 LA 菌株与 2 岁时心力衰竭住院的风险存在显着相关性(比值比:6.6 [95% 置信区间:2.6 至 16.6]),甚至根据年龄和性别调整该分析以及 LAVI 正常的患者。

结论本研究的结果提供了关于在 LAVI 中添加 LA 菌株检测 LVEF 保留的患者的 LVDD 的潜在用途和临床相关性的重要见解。

更新日期:2018-10-02
down
wechat
bug