Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failureReportar como inadecuado




Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Cardiovascular Ultrasound

, 8:14

First Online: 21 April 2010Received: 17 March 2010Accepted: 21 April 2010

Abstract

BackgroundThe combination of early transmitral inflow velocity and mitral annular tissue Doppler imaging E-Em ratio is widely applied to noninvasively estimate left ventricular LV filling pressures.
However E-Em ratio has a significant gray zone and its accuracy in patients with heart failure is debated.
Left atrial LA deformation analysis by speckle tracking echocardiography STE was recently proposed as an alternative approach to estimate LV filling pressures.
This study aimed at exploring the correlation of LA longitudinal function by STE and Doppler measurements with direct measurements of LV filling pressures in patients with heart failure.

MethodsA total of 36 patients with advanced systolic heart failure ejection fraction ≤35%, undergoing right heart catheterization, were studied.
Simultaneously to pulmonary capillary wedge pressure PCWP determination, peak atrial longitudinal strain PALS and mean E-Em ratio were measured in all subjects by two independent operators.
PALS values were obtained by averaging all segments global PALS, and by separately averaging segments measured in the 4-chamber and 2-chamber views.

ResultsNot significant correlation was found between mean E-Em ratio and PCWP R = 0.15.
A close negative correlation between global PALS and the PCWP was found R = -0.81, p < 0.0001.
Furthermore, global PALS demonstrated the highest diagnostic accuracy AUC of 0.93 and excellent sensitivity and specificity of 100% and 93%, respectively, to predict elevated filling pressure using a cutoff value less than 15.1%.
Bland-Altman analysis confirmed this close agreement between PCWP estimated by global PALS and invasive PCWP mean bias 0.1 ± 8.0 mmHg.

ConclusionIn a group of patients with advanced systolic heart failure, E-Em ratio correlated poorly with invasively obtained LV filling pressures.
However, LA longitudinal deformation analysis by STE correlated well with PCWP, providing a better estimation of LV filling pressures in this particular clinical setting.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-7120-8-14 contains supplementary material, which is available to authorized users.

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Autor: Matteo Cameli - Matteo Lisi - Sergio Mondillo - Margherita Padeletti - Piercarlo Ballo - Charilaos Tsioulpas - Sonia Bernaz

Fuente: https://link.springer.com/article/10.1186/1476-7120-8-14



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