Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction

Patel, Dharmendrakumar A.; Lavie, Carl J.; Gilliland, Yvonne; Shah, Sangeeta; Dinshaw, Homeyar; Milani, Richard V.

doi:10.1016/j.mayocp.2015.07.021

Cited by 48 publications

(36 citation statements)

References 30 publications

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“…Introduction of LA volume determination in everyday clinical practice reveals a significant predictive value of LA volume and LA phasic function in general population. 25,26 Additionally, LA phasic function is associated with LV systolic and diastolic function 27,28 and represents a good predictor of atrial fibrillation occurrence or recurrence. [29][30][31] Previous investigations have shown that LA is enlarged and dysfunctional in SSc patients.…”

Section: Discussionmentioning

confidence: 99%

Left atrial phasic function and heart rate variability in patients with systemic sclerosis: A new part of the old puzzle

Tadić

Zlatanović²,

Cuspidi

et al. 2017

Echocardiography

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Section: Discussionmentioning

confidence: 99%

Left atrial phasic function and heart rate variability in patients with systemic sclerosis: A new part of the old puzzle

Tadić

Zlatanović²,

Cuspidi

et al. 2017

Echocardiography

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“…In addition, LA remodeling could significantly contribute to increased morbidity and mortality in MH. In this context, recent findings by Gupta and colleagues and Patel and colleagues showed that LA enlargement, as well as LV dysfunction and LV impaired mechanics, was associated with adverse outcomes in the general population. Thus, it appeared that the comprehensive assessment of LA phasic function may be of clinical importance in MH patients and might be helpful in the risk stratification of these patients.…”

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confidence: 93%

Masked Hypertension and Left Atrial Dysfunction: A Hidden Association

Tadić

Cuspidi

Radojkovic

et al. 2016

J of Clinical Hypertension

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3Masked hypertension (MH) is a clinical condition that indicates normal values of clinic blood pressure (BP) but elevated 24-hour BP. The purpose of this study was to investigate the relationship between MH and left atrial (LA) phasic function evaluated by both the volumetric and speckle tracking method. This cross-sectional study included 49 normotensive individuals, 50 patients with MH, and 70 untreated sustained hypertensive patients adjusted by age and sex. MH was diagnosed if clinic BP was normal and 24-hour BP was increased. LA reservoir function was lower in patients with MH and those with sustained hypertension compared with the normotensive group. LA conduit function gradually decreased, while LA booster pump function progressively increased, from normotension to sustained hypertension. Similar results were obtained by two-dimensional echocardiographic strain analysis. Independently of main clinic and echocardiographic characteristics, 24-hour systolic BP was associated with LA passive ejection fraction, LA total longitudinal strain, LA positive longitudinal strain, and LA stiffness index. In conclusion, MH is associated with impairment of LA phasic function and stiffness, and 24-hour systolic BP increment was closely related with LA remodeling. J Clin Hypertens (Greenwich). 2017;19:305-311. ª2016 Wiley Periodicals, Inc.At the beginning of the new millennium, the increasing use of ambulatory blood pressure (BP) monitoring (ABPM) has revealed the whole range of different BP patterns such as white-coat hypertension, sustained hypertension, nocturnal hypertension, and normotension. This was the reason for the introduction of 24-hour ABPM in guidelines regarding diagnosis of arterial hypertension and in everyday clinical practice. ABPM could provide true and prognostic information on BP variability in hypertensive patients.1 Recent analysis shows important prognostic value of BP variability, assessed by 24-hour ABPM, in white-coat hypertension among older patients. 2Thomas Pickering was the first to use the term masked hypertension (MH).3 Shortly thereafter investigations appeared that demonstrated a negative influence of MH on target organ damage, including cardiac hypertrophy, carotid atherosclerosis, and albuminuria. [4][5][6] These changes could explain the unfavorable prognosis of patients with MH and increased cardiovascular morbidity and mortality in this population. 7,8 Our recent meta-analysis included 776 patients with MH and showed that MH is associated with significant risk of left ventricular (LV) structural changes, primarily LV hypertrophy. 9Left atrial (LA) remodeling has not been sufficiently investigated in MH so far. Sincer and colleagues 10 provided data only on LA diameter, without any further details regarding LA volume (LAV) and phasic function, and they did not find a significant difference between normotensive control, sustained hypertensive, and MH patients. 10 In addition, LA remodeling could significantly contribute to increased morbidity and mortality in MH. In this context, rec...

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“…LA index volume (LAVI) is one of echocardiographic markers to be evaluated according to European Society of Cardiology (ESC) guidelines for the management of AH [1]. The LAVI predicts mortality risk, independent of left ventricular (LV) geometry, in patients with preserved ejection fraction [2]. The cut-off value more than 34 ml/m 2 considered to be pathological both in men and women.…”

Section: Introductionmentioning

confidence: 99%

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

Kolesnyk

Sokolova

2018

ZMJ

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Left atrium (LA) state reflects the severity of cardiovascular remodeling and indicates the degree of compensation in many cardiovascular diseases, including arterial hypertension (AH). Transthoracic echocardiography determines linear and volumetric parameters of LA, but it has limitations in early stages of AH. Speckle tracking echocardiography is a new technique which can identify early subclinical dysfunction of cardiac chambers.The purpose of the study was 1) to assess feasibility, intra-and inter-observer reproducibility of LA longitudinal strain (LS) derived by both P-and R-wave triggering method; 2) to compare LA strain values obtained by P-and R-wave synchronization in hypertensive postmenopausal women. Material and methods.The study involved 65 post-menopausal hypertensive women (mean age -56.8 ± 8.15 years). All patients underwent a standard transthoracic and two-dimensional speckle tracking echocardiography using Vivid E9 XDClear Console 4D Expert 100 (General Electric, USA). Apical four-and two-chamber views images were obtained during breath hold with ECG synchronization. All statistical analyses were performed using SPSS 20 for Windows (SPSS, Inc., Chicago, IL).Results. Initial feasibility of echocardiographic data for performing LA strain analysis was 93.85 %. Adequate tracking quality was achieved in 96.93 % of segments by P-triggering and in 96.35 % by R -wave as initial point of analysis. The intra-class correlation (ICC) coefficient for R-triggering was 0.96 (95 % CI 0.89-0.98) for intra-observer and 0.94 (95 % CI -0.52-0.97) for inter-observer variability. The ICC coefficients for P-triggering were higher 0.97 (95 % CI 0.92-0.99) and 0.96 (95 % CI -0.9-0.98), respectively. The Bland-Altman statistic confirmed absence of bias in both variants of ECG-triggering. Values of LA LS calculated by R-triggering method were significantly higher than those ones by P-triggering (P < 0.001). Conclusions.Speckle tracking echocardiography is a reliable technique, which provides quantitative assessment of LA physiology. The P-wave triggering method of LA strain analysis is more reproducible compared with R-wave triggering variant. The LA LS values differ significantly depending on ECG-triggering type (P-or R wave), providing higher values by R-wave triggering method.Надійність двовимірної спекл-трекінг ехокардіографії при оцінюванні функції лівого передсердя в жінок у стані менопаузи з гіпертонічною хворобоюСтан лівого передсердя (ЛП) показує тяжкість серцево-судинного ремоделювання та вказує на ступінь компенсації багатьох серцево-судинних захворювань, у тому числі гіпертонічної хвороби (ГХ). Трансторакальна ехокардіографія визначає лінійні та об'ємні параметри ЛП, але має обмеження на ранніх стадіях ГХ. Спекл-трекінг ехокардіографія -це нова методика, що дає змогу ідентифікувати ранню субклінічну дисфункцію камер серця.Мета роботи -оцінити технічну можливість визначення, а також внутрішньо-та міждослідницьку відтворю-ваність поздовжнього стрейна ЛП, синхронізованого з P-та R-зубцями ЕКГ; порівняти значення...

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Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction

Abstract: LAE was independently associated with an increased risk of all-cause mortality in our large cohort of 10,719 patients with normal LV filling pressure and preserved LVEF.

Cited by 48 publications

References 30 publications

Left atrial phasic function and heart rate variability in patients with systemic sclerosis: A new part of the old puzzle

Left atrial phasic function and heart rate variability in patients with systemic sclerosis: A new part of the old puzzle

Masked Hypertension and Left Atrial Dysfunction: A Hidden Association

Reliability of two-dimensional speckle tracking echocardiography in assessment of left atrial function in postmenopausal hypertensive women

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