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Impact of left atrial enlargement on 2-dimensional strain |
계명대학교 동산의료원 심장내과 |
김형섭, 김미영, 전진화, 신홍원, 김현태, 김인철, 전동환, 조윤경, 박형섭, 윤혁준, 남창욱, 한성욱, 허승호, 김윤년, 김권배 |
Background
Left atrial (LA) volume (LAV) is believed to reflect the diastolic function of left ventricle (LV), which has been recently assessed by 2-dimensional (2D) strain echocardiography. However, the extent to which enlarged LAV per se influence the longitudinal, circumferential and radial strain (St) or strain rate (SR) is unclear.
Methods
One hundred two subjects (78 enlarged and 24 normal LAV index individuals) underwent conventional echocardiography including LAV. Global longitudinal, radial and circumferential deformations were acquired by 2D-strain.
Results
The subjects with high LAV index had more enlarged LV dimension, higher LV mass index and higher early mitral inflow to mitral annulus velocity (E/Em). With regard to 2D St and SR, lower values of circumferential late diastolic SR (SR-a) were found to be most associated with greater in LAV index, whereas longitudinal and radial St and SR were not. In multivariate regression, the most independent variable correlated with LAV index was circumferential SR-a (odds ratio [CI]: -16.48 [-26.08, -6.89], p=0.001) in addition to E/Em and LV mass index. Furthermore, circumferential SR-a showed a good correlation with LAV among whole subjects (r=0.45).
Conclusion
Independently of LV mass index, enlarged LAV would primarily affect diastolic function, particularly as regards circumferential SR-a, which might be considered a robust index for the assessment of diastolic dysfunction.
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