P736Assessment of left atrial function by 2D strain using velocity vector imaging in patients with systolic heart failure


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Abstract

Objectives: 2D Strain by speckle tracking is a simple and reproducible technique for assessing regional myocardial function, however, its' usage for evaluation of LA function is less studied. Background: We sought to assess LA function in heart failure patients using 2D strain.Methods: Thirty five patients (mean age: 43.34±18.1 years, 59.3% male) with systolic dysfunction (LVEF < 35%) were enrolled. Standard Doppler echocardiography and 2D strain performed in all subjects. Strain measurements obtained from apical views.Results: A significant differences in LA volume index (LAVI) and strain were found in HF patients (23.8±4.1 versus 57.8±19.7 ml/m2, PV<0.0001 and 39.6±10.6 versus 8.2±5.3%, PV<0.0001). In multivariate analysis, significant inverse relation were found between LAVI and LA strain in 4-chamber (45.6±22 versus 8.5±5.6%, r = -0.4, PV=0.01), 2-chamber (40.2±14.3 versus 8.7±8.2%, r = -0.4, PV=0.007) and average LA strain (39.6±10.6 versus 8.2±5.3%, r = -0.3, PV=0.01). Significant inverse relation were also detected between pulmonary artery systolic pressure and both total LA strain (22±8 versus 42±10 mmHg, r = -0.4, PV=0.004) and LA strain in 2-chamber (r = -0.5, PV=0.001) [anterior (43.2±25.4 versus 10.3±8%, r = -0.4, PV=0.004), inferior (54.7+-25.9 versus 9.2±11.4%, r = -0.5, PV<0.001) and roof (22.6±11.4 versus 6.4±7.4%, r = -0.4,PV=0.01)]. A cut off value of 17.2% for total average LA strain has a sensitivity of 100% and specificity of 97% to diagnose LA myocardial dysfunction.Conclusion: 2D strain can reliably detect impaired LA function in heart failure patients. LA volume index and strain are powerful determinants of LA myocardial dysfunction.

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