Left atrial reservoir strain provides incremental value to left atrial volume index for evaluation of left ventricular filling pressure.
Background: Left atrial analysis is employed in diastolic assessment with left atrial volume index (LAVI) incorporated in the 2016 ASE/EACVI diastology guideline algorithm. LAVI has sub‐optimal correlation with invasive left ventricular filling pressure (LVFP) and incorporation of left atrial reserv...
| Publicado en: | Echocardiography Vol. 38; no. 9; pp. 1503 - 1514 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Sep2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153877932&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153877932 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07422822 GSE jtl: Echocardiography issn: 07422822 maglogo: Y pubinfo: dt: Sep2021 vid: 38 iid: 9 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 153877932 151761917 153877932 153877932 10.1111/echo.15157 153877932 ppf: 1503 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Left atrial reservoir strain provides incremental value to left atrial volume index for evaluation of left ventricular filling pressure. aug: au: Tomlinson, Stephen Scalia, Gregory M. Appadurai, Vinesh Edwards, Natalie Savage, Michael Lam, Alfred K‐Y. Chan, Jonathan affil: Department of Cardiology, The Prince Charles Hospital, Brisbane, Australia sug: subj: Heart Atrium, Left Physiopathology Atrial Fibrillation Ventricular Dysfunction, Left Physiopathology Ventricular Pressure Human Cross Sectional Studies Prospective Studies Echocardiography Descriptive Statistics Algorithms Male Female Middle Age Aged ROC Curve Sensitivity and Specificity Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background: Left atrial analysis is employed in diastolic assessment with left atrial volume index (LAVI) incorporated in the 2016 ASE/EACVI diastology guideline algorithm. LAVI has sub‐optimal correlation with invasive left ventricular filling pressure (LVFP) and incorporation of left atrial reservoir strain (LASr) may improve diastolic assessment. Methods: A cross‐sectional prospective study of 139 patients was undertaken with all patients undergoing transthoracic echocardiography immediately prior to cardiac catheterization with invasive evaluation of LVFP. LASr by speckle tracking echocardiography and conventional echocardiographic parameters were assessed in relation to invasive LVFP. Modification of the 2016 guideline algorithm was performed with incorporation of LASr in place of LAVI (LASr ≤23% indicating elevated LVFP). Accuracy of the modified and conventional algorithm were assessed for predicting invasive LVFP. Results: The mean age was 63±12 years with 27% female. LASr demonstrated superior correlation and receiver operator characteristic for predicting LVFP than LAVI (LASr: r ‐.46 (p < 0.01), AUC:.82 vs LAVI: r.19 (p 0.02), AUC:.66). LASr of ≤23% was the optimal cut‐off for discriminating elevated LVFP (sensitivity 80%, specificity 77%). Modification of the 2016 algorithm with incorporation of LASr in place of LAVI reclassified 12% of the patient cohort and improved concordance of echocardiographic and invasive LVFP assessment (modified algorithm κ.47 vs 2016 algorithm κ:.33). No patients were incorrectly reclassified by modified algorithm assessment. Conclusions: LASr better predicts invasive LVFP than LAVI. Modification of the 2016 guideline algorithm with incorporation of LASr in place of LAVI improves accuracy of echocardiographic assessment of LVFP. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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