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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
Published on: October 28, 2020
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Left atrial function: Correlation with left ventricular function and contractile reserve in patients with
Matle J Fung1,2, Liza Thomas1,2,3,4, Dominic Y Leung1,2
1Cardiology Department, Liverpool Hospital, Liverpool, Sydney, NSW, Australia.
Echocardiography (Mount Kisco, N.Y.)
|June 27, 2018
Summary
Hypertension impairs left atrial (LA) strain, which correlates with left ventricular (LV) global longitudinal strain (GLS) and contractile reserve (CR). LV GLS is a key determinant of LA function in hypertensive patients.
Area of Science:
- Cardiology
- Echocardiography
- Hypertension Research
Background:
- Left atrial (LA) and left ventricular (LV) dysfunction are known complications of hypertension.
- The relationship between LA functional alterations and LV changes in hypertensive individuals remains unclear.
- This study investigates the correlation between LA strain and LV function, including contractile reserve (CR).
Purpose of the Study:
- To assess left atrial (LA) functional changes in hypertensive patients using strain deformation analysis.
- To determine the relationship between LA strain and left ventricular (LV) functional changes, including contractile reserve (CR).
- To compare LA and LV function in hypertensive patients versus normotensive controls.
Main Methods:
- 116 patients (67 hypertensive) underwent dobutamine echocardiography, excluding those with significant coronary/valvular disease, prior myocardial infarction, or diabetes.
- Measurements included resting LA reservoir (Ɛs), conduit (Ɛe), and atrial contractile (Ɛa) strain.
- LV global longitudinal strain (GLS) and ejection fraction (LVEF) were assessed at rest and during dobutamine stress to calculate LV CR.
Main Results:
- Hypertensive patients exhibited significantly impaired LA Ɛs, Ɛe, and Ɛa compared to controls (P < .001).
- All LA phasic strain parameters correlated with LV GLS at rest, during dobutamine stress, and with LV CR.
- LV GLS and maximal LA volume index (LAVImax) were the strongest independent predictors for LA Ɛs/Ɛe and LA Ɛa, respectively, irrespective of blood pressure and LV mass index.
Conclusions:
- Hypertensive patients demonstrate reduced LA strain, which is significantly correlated with LV GLS and CR.
- LV GLS and LAVImax are key independent determinants of LA reservoir/conduit strain and LA contractile strain, respectively.
- These findings highlight the interconnectedness of LA and LV function in the context of hypertension.
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