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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 2  |  Page : 532-539

Assessment of left atrial function in patients with systolic heart failure: strain imaging study


Department of Cardiology, Faculty of Medicine, Menoufia University, Menoufia, Egypt

Correspondence Address:
Rania S Abd El-Ghani
Department of Cardiology, Faculty of Medicine, Menoufia University, BadeaKhairy Street, Al Nozha, Cairo
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.163914

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Objectives The aim of this work was to assess the left atrial function by speckle tracking in patients with systolic heart failure. Background Heart failure is a clinical syndrome characterized by impaired structure and/or function of the heart, leading to dyspnea and fatigue at rest or with exertion. The pathophysiology of heart failure is complex and there is no single lesion. The left atrial function contributes toward left ventricular filling by means of its three components: a reservoir component; a passive conduit component; and a pump component, with active contraction. Changes in atrial function during the different phases of the cardiac cycle can be assessed noninvasively by the new 2D strain, derived from speckle tracking, that allows us to identify these three components of atrial function. Materials and methods This study included 50 randomly selected individuals: 30 with systolic heart failure and ejection fraction (EF) less than 50% (patient group) and 20 normal individuals (control group). Left ventricle (LV) volumes were measured. Left atrium (LA) volumes were measured at the end of systole, LA maximum volume (Max AV), at the end of diastole, LA minimum volume (Min AV), and preceding atrial contraction (VPre-A). LA total emptying volume (LAEV), LA total emptying fraction(LAEF), LA passive emptying volume (LApEV), LA passive emptying fraction (LApEF), LA active emptying volume (LAAEV), and LA active emptying fraction (LAAEF) were calculated in both apical four-chamber and apical two-chamber views. Peak atrial longitudinal strain, peak atrial contraction strain, and LA strain at the end of LA contraction (Post-A) were measured. The LA contraction systolic index was calculated. LV global strain was measured in apical four-chamber, two-chamber and three-chamber views. LV strain rate was determined, and the LV peak systolic, early diastolic, and late diastolic strain rate were measured. Results Patients with systolic heart failure showed a significant increase in LV volumes and LA volumes (Max AV, Min AV, and VPre-A volumes) compared with the control group. A significant decrease in LA peak atrial longitudinal strain, peak atrial contraction strain, Post-A, and LA contraction systolic index was observed in patients with systolic heart failure (P < 0.001). Also, there was a decrease in LAEV, LAEF, LApEV, LApEF, LAAEV, and LAAEF in patients with systolic heart failure compared with the control group. Conclusion Increased LA volumes and decreased LA function were measured by strain and volumetric parameters in patients with systolic heart failure compared with controls.


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