Left Atrial Strain for assessment of left ventricle diastolic dysfunction in acute coronary syndrome patients

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Published Jun 28, 2024
https://doi.org/10.62438/tunismed.v102i7.4875
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Vol. 102 No. 7 (2024): Tunis Med jul 2024

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Saoussen Antit
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Marwa Abdelhedi
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Ridha Fekih
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Khalil Bahri
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Elhem Boussabeh
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia
Lilia Zakhama
Department of Cardiology, Security Forces Hospital, La Marsa, University of Tunis El Manar, Faculty of Medicine of Tunis, Tunisia

Abstract

Introduction: Patients with acute coronary syndrome (ACS) have a high incidence of Left ventricle diastolic dysfunction (DD). Latest algorithms for the assessment of DD lay on 2D parameters and describe a grading to quantify its severity. However, there persists a “gray zone” of values in which DD remains indeterminate.


Aim:  to analyze the diagnostic value of Left atrium strain (LAS) for categorization of LV DD and assessment of LV filling pressures in ACS patients.


Methods:  Cross-sectional study that prospectively evaluated 105 patients presenting ACS with preserved LV ejection fraction (LVEF). Patients were divided in 4 groups according to the DD grade.


Mean values of LAS, corresponding to three phases of atrial function: reservoir (LASr), conduit (LAScd) and contraction (LASct), were obtained by speckle-tracking echocardiography.


Results:  Mean age was 60±10 years, with a gender ratio of 6.14. LASr and LASct were significantly lower according to DD severity (p combined=0.021, p combined=0.034; respectively). E/e’ ratio was negatively correlated to LASr (r= - 0.251; p= 0.022) and LASct (r= -0.197; p=0.077). Left atrial volume index (LAVI) was also negatively correlated to LASr (r= -0.294, p= 0.006) and LASct (r= -0.3049, p=0.005). Peak tricuspid regurgitation was negatively correlated to LASr (r=-0.323, p=0.017) and LASct (r=-0.319, p=0.020). ...( abstract truncated at 250 words)

Keywords:

Left atrial function , Left ventricular diastolic function , Speckle-tracking echocardiography , Acute coronary syndrome, Left atrial strain

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