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Related Experiment Video

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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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LA Strain for Categorization of LV Diastolic Dysfunction.

Amita Singh1, Karima Addetia1, Francesco Maffessanti1

  • 1Section of Cardiology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois.

JACC. Cardiovascular Imaging
|December 27, 2016
PubMed
Summary

Left atrial (LA) strain effectively detects and classifies diastolic dysfunction (DD) severity. This novel echocardiographic measure offers a progressive assessment tool, unlike traditional parameters, for improved clinical evaluation of heart function.

Keywords:
diastolic functionleft atrial strainleft atriummyocardial strain

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Area of Science:

  • Cardiology
  • Echocardiography
  • Diastolic Heart Function

Background:

  • Diastolic dysfunction (DD) assessment is complex; conventional parameters lack sensitivity to its progression.
  • Left atrial (LA) strain is an emerging index of LA function, diminished in diastolic heart failure.
  • LA strain is not yet a standard parameter for diastolic function assessment.

Purpose of the Study:

  • To investigate the relationship between LA strain and left ventricular diastolic function.
  • To determine if LA strain can detect DD and classify its severity.
  • To test the hypothesis that LA strain decreases stepwise with worsening DD.

Main Methods:

  • Retrospective derivation and validation cohort study (N=229) with preserved ejection fraction.
  • Two-dimensional speckle-tracking echocardiography to measure peak LA strain.
  • LA strain used as a single parameter to classify DD grades (0-3) against ASE guidelines.

Main Results:

  • Peak LA strain significantly differed between DD groups, decreasing with severity in the derivation cohort (n=90).
  • Three LA strain thresholds demonstrated good to excellent diagnostic utility (AUC 0.86-0.91) for DD grading.
  • In validation (n=139), LA strain achieved up to 95% diagnostic accuracy, resolving indeterminate cases.

Conclusions:

  • LA strain measurement is feasible and accurately categorizes DD severity.
  • LA strain changes progressively with DD severity, unlike traditional parameters.
  • LA strain shows potential as a valuable tool for future diastolic function assessment.