Left atrial strain by speckle tracking predicts atrial fibrosis in patients undergoing heart transplantation

Abstract Aims In patients with heart failure (HF), chronically raised left ventricular (LV) filling pressures lead to progressive left atrial (LA) dysfunction and fibrosis. We aimed to assess the correlation of LA reservoir strain (peak atrial longitudinal strain, PALS) by speckle tracking echocardi...

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Published in:European heart journal cardiovascular imaging 2022-06, Vol.23 (6), p.829-835
Main Authors: Lisi, Matteo, Mandoli, Giulia Elena, Cameli, Matteo, Pastore, Maria Concetta, Righini, Francesca Maria, Benfari, Giovanni, Rubboli, Andrea, D’Ascenzi, Flavio, Focardi, Marta, Tsioulpas, Charilaos, Bernazzali, Sonia, Maccherini, Massimo, Lisi, Edoardo, Lindqvist, Per, Valente, Serafina, Mondillo, Sergio, Henein, Michael Y
Format: Article
Language:English
Subjects:
Adult
Echocardiography - methods
Female
Fibrosis
Heart Atria - diagnostic imaging
heart failure
Heart Failure - diagnostic imaging
Heart Failure - surgery
Heart Transplantation
Humans
left atrial
Male
Middle Aged
speckle tracking
strain
Stroke Volume
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Summary:Abstract Aims In patients with heart failure (HF), chronically raised left ventricular (LV) filling pressures lead to progressive left atrial (LA) dysfunction and fibrosis. We aimed to assess the correlation of LA reservoir strain (peak atrial longitudinal strain, PALS) by speckle tracking echocardiography (STE) and LA fibrosis assessed by myocardial biopsy in patients undergoing heart transplantation (HTx). Methods and results Forty-eight patients with advanced HF [mean age 51.2 ± 8.1 years, 29% females; LV ejection fraction ≤25% and New York Heart Association (NYHA) class III–IV] referred for HTx were enrolled and underwent pre-operative echocardiographic evaluation, right heart catheterization, and cardiopulmonary exercise testing. Exclusion criteria were non-sinus rhythm, mechanical ventilation, severe mitral/tricuspid regurgitation, or other valvular disease and poor acoustic window. After HTx, LA bioptic samples were collected and analysed to determine the extent of myocardial fibrosis (%). LA fibrosis showed correlation with PALS (R = −0.88, P 
ISSN:2047-2404
2047-2412
2047-2412
DOI:10.1093/ehjci/jeab106