Diagnostic value of Left Atrial Strain and NT-ProBNP in the Diagnosis of HFpEF

Abstract

Introduction

Heart failure with preserved ejection fraction (HFpEF) poses diagnostic challenges due to its heterogeneous presentation.

Objective

This prospective study aimed to assess the utility of left atrial (LA) strain measured by echocardiography and NT-ProBNP levels in diagnosing HFpEF.

Method

We enrolled 110 consecutive participants who underwent comprehensive echocardiography, including assessment of left atrial strain using speckle tracking. NT-ProBNP levels were measured concurrently. A continuous diagnostic score for HFpEF was calculated based on the European Society of Cardiology's HFA-PEFF diagnostic algorithm.

Results

Mean age was 61.8 ± 11.5 years; 57.3% female. Hypertension and Diabetes were the most common cardiovascular risk factor (90% and 60% respectively). In the study population, 44 patients (40%) had a confirmed diagnosis of HFpEF according to the HFA-PEFF score, after evaluation at rest and on exertion. The median PALS was 26% ± 7.6. Exploration objected a median N-terminal pro-BNP (NT-pro-BNP) of 95 pg/mL [52–247]. A Value of NT Pro-BNP > 125 pn/mL was found in 42% patients. LA strain reservoir was significatively correlated with NT Pro-BNP (P = 0.049, r = −0.14).

Conclusion

Assessment of LA strain using speckle tracking echocardiography, alongside NT-ProBNP levels, shows promise in diagnosing HFpEF. These non-invasive measures offer valuable insights into cardiac dysfunction and may aid in early detection and management of HFpEF.