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The validation of left atrial strain imaging for the assessment of diastolic functions in patients with ST-segment

Eser Durmaz1, Mehmet Hakan Karpuz2, Baris İkitimur2

  • 1Department of Cardiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Kocamustafapasa Street, Fatih, Istanbul, 34098, Turkey. durmazeser@hotmail.com.

The International Journal of Cardiovascular Imaging
|September 19, 2023
PubMed

Insights

Left atrial reservoir strain (LARS) imaging shows promise for assessing left ventricular filling pressure in ST-segment elevation myocardial infarction (STEMI) patients post-primary percutaneous coronary intervention (pPCI). This method offers a more comprehensive evaluation than current echocardiographic parameters.

Area of Science:

  • Cardiology
  • Echocardiography
  • Myocardial Infarction Research

Background:

  • Accurate assessment of left ventricular filling pressure (LVFP) is critical for ST-segment elevation myocardial infarction (STEMI) patients.
  • Current echocardiographic methods for LVFP assessment in STEMI patients have limitations.
  • Novel imaging techniques are needed for comprehensive LVFP evaluation in this population.

Purpose of the Study:

  • To investigate the clinical utility of left atrial reservoir strain (LARS) imaging.
  • To assess LARS as a tool for evaluating left ventricular filling pressure (LVFP) in STEMI patients undergoing primary percutaneous coronary intervention (pPCI).
  • To compare LARS with invasive left ventricular end-diastolic pressure (LVEDP) measurements.

Main Methods:

  • Prospective study of 69 STEMI patients successfully treated with pPCI.
  • Invasive left ventricular end-diastolic pressure (LVEDP) measurement post-pPCI.
  • Left atrial strain (LARS) imaging performed within 24 hours post-pPCI; normal LARS defined as >23%.

Main Results:

  • Patients with LARS < 23% (Group 1) had significantly higher Troponin and pro-BNP levels compared to Group 2 (LARS > 23%).
  • Group 1 exhibited higher left ventricular (LV) global longitudinal strain and lower ejection fraction (LVEF).
  • Estimated mean LVFP was significantly higher in Group 1 (p=0.003), with a moderate inverse correlation found between LARS and LVEDP (r=-0.300).

Conclusions:

  • Left atrial reservoir strain (LARS) imaging is a potential non-invasive tool for assessing left atrial pressure.
  • LARS provides valuable insights into LVFP in STEMI patients post-pPCI.
  • Further research is warranted to validate LARS as a standard clinical assessment method.

Keywords:
Diastolic dysfunctionLeft atrial strainLeft ventricular end-diastolic pressureSTEMI

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