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Inoue K, Khan FH, Remme EW, et al. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021;23(1):61-70doi: 10.1093/ehjci/jeaa415.
Inoue, K., Khan, F. H., Remme, E. W., Ohte, N., García-Izquierdo, E., Chetrit, M., Moñivas-Palomero, V., Mingo-Santos, S., Andersen, �. �. S., Gude, E., Andreassen, A. K., Wang, T. K. M., Kikuchi, S., Stugaard, M., Ha, J. W., Klein, A. L., Nagueh, S. F., & Smiseth, O. A. (2021). Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. European heart journal. Cardiovascular Imaging, 23(1), 61-70. https://doi.org/10.1093/ehjci/jeaa415
Inoue, Katsuji, et al. "Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure." European heart journal. Cardiovascular Imaging vol. 23,1 (2021): 61-70. doi: https://doi.org/10.1093/ehjci/jeaa415
Inoue K, Khan FH, Remme EW, Ohte N, García-Izquierdo E, Chetrit M, Moñivas-Palomero V, Mingo-Santos S, Andersen ØS, Gude E, Andreassen AK, Wang TKM, Kikuchi S, Stugaard M, Ha JW, Klein AL, Nagueh SF, Smiseth OA. Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure. Eur Heart J Cardiovasc Imaging. 2021 Dec 18;23(1):61-70. doi: 10.1093/ehjci/jeaa415. PMID: 33496314; PMCID: PMC8685600.
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Eur Heart J Cardiovasc Imaging. 2021 Dec 18;23(1):61-70. doi: 10.1093/ehjci/jeaa415.

Determinants of left atrial reservoir and pump strain and use of atrial strain for evaluation of left ventricular filling pressure.

European heart journal. Cardiovascular Imaging

Katsuji Inoue, Faraz H Khan, Espen W Remme, Nobuyuki Ohte, Eusebio García-Izquierdo, Michael Chetrit, Vanessa Moñivas-Palomero, Susana Mingo-Santos, Øyvind S Andersen, Einar Gude, Arne K Andreassen, Tom Kai Ming Wang, Shohei Kikuchi, Marie Stugaard, Jong-Won Ha, Allan L Klein, Sherif F Nagueh, Otto A Smiseth

Affiliations

  1. Institute for Surgical Research and Department of Cardiology, Rikshospitalet, Oslo University Hospital, and University of Oslo, N-0027 Oslo, Norway.
  2. Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Toon, Japan.
  3. Department of Cardiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
  4. Department of Cardiology, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
  5. Department of Cardiovascular Medicine, McGill University Health Centre, Montreal, Canada.
  6. Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, OH, USA.
  7. Department of Cardiology, Ringerike Hospital, Vestre Viken Hospital Trust, Hønefoss, Norway.
  8. Cardiology Division, Yonsei University College of Medicine, Seoul, Korea.
  9. Department of Cardiology, Methodist DeBakey Heart and Vascular Center, Houston, Texas, USA.

PMID: 33496314 PMCID: PMC8685600 DOI: 10.1093/ehjci/jeaa415

Abstract

AIMS: The aim of this study is to investigate determinants of left atrial (LA) reservoir and pump strain and if these parameters may serve as non-invasive markers of left ventricular (LV) filling pressure.

METHODS AND RESULTS: In a multicentre study of 322 patients with cardiovascular disease of different aetiologies, LA strain and other echocardiographic parameters were compared with invasively measured LV filling pressure. The strongest determinants of LA reservoir and pump strain were LV global longitudinal strain (GLS) (r-values 0.64 and 0.51, respectively) and LV filling pressure (r-values -0.52 and -0.57, respectively). Left atrial volume was another independent, but weaker determinant of both LA strains. For both LA strains, association with LV filling pressure was strongest in patients with reduced LV ejection fraction. Left atrial reservoir strain <18% and LA pump strain <8% predicted elevated LV filling pressure better (P < 0.05) than LA volume and conventional Doppler parameters. Accuracy to identify elevated LV filling pressure was 75% for LA reservoir strain alone and 72% for pump strain alone. When combined with conventional parameters, accuracy was 82% for both LA strains. In patients with normal LV systolic function by GLS, LA pump strain >14% identified normal LV filling pressure with 92% accuracy.

CONCLUSION: Left atrial reservoir and pump strain are determined predominantly by LV GLS and filling pressure. Accuracy of LA strains to identify elevated LV filling pressure was best in patients with reduced LV systolic function. High values of LA pump strain, however, identified normal LV filling pressure with good accuracy in patients with normal systolic function.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.

Keywords: catheterization; diastolic dysfunction; heart failure; left atrial strain; left ventricular filling pressure

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