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Left atrial strain as a predictor of left ventricular filling pressures in coronary artery disease with preserved ejection fraction: a comprehensive study with left ventricular end-diastolic and pre-atrial contraction pressures
Assessing left ventricular (LV) filling pressure (LVFP) is challenging in patients with coronary artery disease (CAD) and preserved LV ejection fraction (LVEF). We aimed to correlate left atrial strain (LAS) with two invasive complementary parameters of LVFP and compared its accuracy to other echoca...
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| Published in: | The international journal of cardiovascular imaging 2023-11, Vol.39 (11), p.2193-2204 |
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| container_title | The international journal of cardiovascular imaging |
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| creator | Nishida, Gustavo Calvilho Junior, Antonio Amador Assef, Jorge Eduardo dos Santos, Natasha Soares Simões de Andrade Vilela, Andrea Braga, Sergio Luiz Navarro |
| description | Assessing left ventricular (LV) filling pressure (LVFP) is challenging in patients with coronary artery disease (CAD) and preserved LV ejection fraction (LVEF). We aimed to correlate left atrial strain (LAS) with two invasive complementary parameters of LVFP and compared its accuracy to other echocardiographic data to predict high LVFP. This cross-sectional, single-center study enrolled 81 outpatients with LVEF > 50% and significant CAD from a database. Near-simultaneous echocardiography and invasive measurements of both LV end-diastolic pressure (LVEDP) and LV pre-atrial contraction (pre-A) pressure were performed in each patient, based on the definition of LVEDP > 16 mmHg and LV pre-A > 12 mmHg as high LVFP. A moderate to strong correlation was observed between LAS reservoir (LASr), contractile strain, and LVEDP (r: 0.67 and 0.62, respectively; p |
| doi_str_mv | 10.1007/s10554-023-02938-3 |
| format | article |
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Graphical abstract</description><subject>Algorithms</subject><subject>Blood pressure</subject><subject>Cardiac Imaging</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Contractility</subject><subject>Coronary artery disease</subject><subject>Coronary vessels</subject><subject>Diastolic pressure</subject><subject>Echocardiography</subject><subject>Ejection fraction</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Paper</subject><subject>Parameter identification</subject><subject>Radiology</subject><subject>Vein & artery diseases</subject><subject>Ventricle</subject><issn>1875-8312</issn><issn>1569-5794</issn><issn>1875-8312</issn><issn>1573-0743</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9kcuOVCEQhk-MJo6jL-CKxI2bo1zOBdyZibekEze6JjQUM3RoaIHTZp53XsTqPpOMGRMXQCV8_18Ff9e9ZvQdo3R-Xxkdx6GnXOBSQvbiSXfB5Dz2UjD-9K_6efei1h2lbBZKXXR3G_CNmFaCiaS2YkIiphJDDgVcsC0Xkj2JJ-gICTG7RFOIDzGGdH2ial1wI6izueRkyi0xpQEeLlQwFcjv0G7OJJQjOAI7sC3kRHwx5-IDtrN5j8QNpBqOgIMs7nbV_dMakutdMLXlGCwxyZ2s-_sX2Izg6vow28vumTexwqv787L7-fnTj6uv_eb7l29XHze9FSNvvRy95VtHuTcDg8FI6vwAxvDBSZBs2o7TzBWlUoG3FLyCeZ4UCLwYt0J6cdm9XX0PJf9aoDa9D9VCjCZBXqrmcqITm_nIEH3zCN3lpSScDikluMBOCim-UrbkWgt4fShhjz-sGdWn3PWau8bc9Tl3LVAkVlFFOF1DebD-j-oPPl-4JQ</recordid><startdate>20231101</startdate><enddate>20231101</enddate><creator>Nishida, Gustavo</creator><creator>Calvilho Junior, Antonio Amador</creator><creator>Assef, Jorge Eduardo</creator><creator>dos Santos, Natasha Soares Simões</creator><creator>de Andrade Vilela, Andrea</creator><creator>Braga, Sergio Luiz Navarro</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M7Z</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-6569-0776</orcidid><orcidid>https://orcid.org/0000-0002-5153-8420</orcidid><orcidid>https://orcid.org/0000-0002-7053-3684</orcidid><orcidid>https://orcid.org/0000-0003-1932-2512</orcidid><orcidid>https://orcid.org/0000-0002-8641-9819</orcidid><orcidid>https://orcid.org/0000-0003-0056-4378</orcidid></search><sort><creationdate>20231101</creationdate><title>Left atrial strain as a predictor of left ventricular filling pressures in coronary artery disease with preserved ejection fraction: a comprehensive study with left ventricular end-diastolic and pre-atrial contraction pressures</title><author>Nishida, Gustavo ; 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We aimed to correlate left atrial strain (LAS) with two invasive complementary parameters of LVFP and compared its accuracy to other echocardiographic data to predict high LVFP. This cross-sectional, single-center study enrolled 81 outpatients with LVEF > 50% and significant CAD from a database. Near-simultaneous echocardiography and invasive measurements of both LV end-diastolic pressure (LVEDP) and LV pre-atrial contraction (pre-A) pressure were performed in each patient, based on the definition of LVEDP > 16 mmHg and LV pre-A > 12 mmHg as high LVFP. A moderate to strong correlation was observed between LAS reservoir (LASr), contractile strain, and LVEDP (r: 0.67 and 0.62, respectively; p < 0.001); the same was true for LV pre-A (r: 0.65 and 0.63, respectively; p < 0.001). LASr displayed good diagnostic performance to identify elevated LVFP, which was higher when compared to traditional parameters. Median value of LASr was higher for an isolated increase of LVEDP than for simultaneously high LV pre-A. The cutoff found to predict high LVFP was lower for LV pre-A than that one for LVEDP. In the current study, LASr did not provide an additional contribution to the 2016 diastolic function algorithm. LAS is a valuable tool for predicting LVFP in patients with CAD and preserved LVEF. The choice of LVEDP or LV pre-A as the representative marker of LVFP leads to different cutoffs to predict high pressures. The best strategy for adding this tool to a multiparametric algorithm requires further investigation.
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| subjects | Algorithms Blood pressure Cardiac Imaging Cardiology Cardiovascular disease Contractility Coronary artery disease Coronary vessels Diastolic pressure Echocardiography Ejection fraction Heart Heart diseases Imaging Medicine Medicine & Public Health Original Paper Parameter identification Radiology Vein & artery diseases Ventricle |
| title | Left atrial strain as a predictor of left ventricular filling pressures in coronary artery disease with preserved ejection fraction: a comprehensive study with left ventricular end-diastolic and pre-atrial contraction pressures |
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