Improving the assessment of left ventricular diastolic dysfunction by including left atrial strain in the algorithm: LA Strain and LV diastolic dysfunction assessment.
Lin Wang, Jonathan Weber, Jason Craft, Michael Passick, Omar K Khalique, Ziad A Ali, Jae K Oh, J Jane Cao
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引用次数: 0
Abstract
Background: The latest guidelines on echocardiographic assessment of left ventricular diastolic dysfunction (LVDD) leave a significant proportion of patients with LVDD status undetermined. We aimed to examine the implication of an alternative algorithm incorporating left atrial (LA) strain as a tiebreaker on the indeterminate LVDD category.
Methods and results: We included 823 patients who underwent echocardiography and cardiac MRI within 7 days. LVDD was assessed by echocardiography following contemporary guidelines and an alternative algorithm including LA reservoir strain as a tie-breaker. LVDD was examined for its association with LV myocardial scar burden by cardiac MRI, and a composite outcome. 275 (33%) patients had LVDD, of whom 119 had advanced grades of LVDD (grade II-III), and 117 (14%) had indeterminate LVDD grade. When LA strain was applied at cut points of 18%, 24% and 35%, subjects were reclassified as normal or LVDD dependent accordingly. Reclassification allowed a similar outcome risk-stratification as the current guidelines.
Conclusions: LA reservoir strain improved LVDD assessment by eliminating indeterminate status/grade while maintaining the same effective outcome stratification as current guidelines.
期刊介绍:
Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.