Determinants of LA reservoir strain: Independent effects of LA volume and LV global longitudinal strain. Issue 12 (19th November 2020)

• Record Type: Journal Article
• Authors: Gan, Gary C.H.; Bhat, Aditya; Chen, Henry H.L.; Fernandez, Fernando; Byth, Karen; Eshoo, Suzanne; Thomas, Liza
• Is Part Of: Echocardiography. Volume 37:Issue 12(2020)
• Page Start: 2018
• Page End: 2028
• Publication Date: 2020-11-19
• Subjects: left atrial reservoir strain -- left atrial strain -- left atrial volume indexed -- left ventricular global longitudinal strain; Echocardiography -- Periodicals; Echocardiography -- Periodicals; 616.1207543
• DOI: 10.1111/echo.14922
• Languages: English
• ISSNs: 0742-2822

Abstract

Abstract: Background: Left atrial (LA) deformation during the reservoir phase (LASr) has demonstrated strong prognostic value in different clinical settings. Although determinants of left atrial reservoir strain including left atrial relaxation, left atrial compliance, and left ventricular longitudinal systolic function are fairly well defined, there is incomplete information regarding the effect of left atrial volume on this relationship which is the focus of our study. Method: Consecutive patients without prior cardiac disease referred for transthoracic echocardiography were prospectively recruited. All participants underwent clinical assessment, transthoracic echocardiography (TTE), and screening exercise stress test. Only patients with normal left ventricular ejection fraction (LVEF) without left ventricular hypertrophy (LVH) or myocardial ischemia on stress testing were included. Results: A total of 260 patients (57% male, mean age 59 ± 14 years) were included. 70% had hypertension, 33% had diabetes mellitus, and 31% had both HTN and DM. On multivariate analysis, age, e', LAVI, and LV GLS ( P < .01 for all) showed an independent association with LASr. Of interest, at lower tertiles of LAVI, a linear decrease in LASr was observed parallel to worsening LV GLS, whilst at higher tertiles of LAVI, the reduction in LASr was non‐linear implying that LA enlargement, consequent to LA remodeling, had an incremental effect on LASr. Conclusion: Age, e', LV GLS, and LAVI were independently associated with LASr. LA remodeling reflected by larger LAVI had an incremental negative association with LASr independent of LV GLS.