Prognostic value of fast semi-automated left atrial long-axis strain analysis in hypertrophic cardiomyopathy

Yang, Fan; Wang, Lili; Wang, Jie; Pu, Lutong; Xu, Yuanwei; Li, Weihao; Wan, Ke; Yang, Dan; Sun, Jiayu; Han, Yuchi; Zhu, Yanjie; Chen, Yu‐Cheng

doi:10.1186/s12968-021-00735-2

Cited by 20 publications

(16 citation statements)

References 27 publications

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“…During a long follow up-up of 40.9 months, 59 patients with HCM (19.7%) out of 359 experienced the composite endpoint of cardiovascular death, resuscitated cardiac arrest, sudden cardiac death aborted by appropriate ICD discharge, and HF hospital admission. Reservoir and conduit components (HR, 0.94 and 0.89; p = 0.019 and 0.006, respectively) emerged as independent predictors of outcome, also after correcting for the extent of LV fibrosis, confirming the prognostic significance of LA mechanics and expanding the clinical applications of CMR-based myocardial deformation analysis ( 47 ).…”

Section: La Mechanics In Hf Stagesmentioning

confidence: 73%

Cardiac Imaging for the Assessment of Left Atrial Mechanics Across Heart Failure Stages

Bandera

Mollo

Frigelli

et al. 2022

Front. Cardiovasc. Med.

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The left atrium (LA) is emerging as a key element in the pathophysiology of several cardiac diseases due to having an active role in contrasting heart failure (HF) progression. Its morphological and functional remodeling occurs progressively according to pressure or volume overload generated by the underlying disease, and its ability of adaptation contributes to avoid pulmonary circulation congestion and to postpone HF symptoms. Moreover, early signs of LA dysfunction can anticipate and predict the clinical course of HF diseases before the symptom onset which, particularly, also applies to patients with increased risk of HF with still normal cardiac structure (stage A HF). The study of LA mechanics (chamber morphology and function) is moving from a research interest to a clinical application thanks to a great clinical, prognostic, and pathophysiological significance. This process is promoted by the technological progress of cardiac imaging which increases the availability of easy-to-use tools for clinicians and HF specialists. Two-dimensional (2D) speckle tracking echocardiography and feature tracking cardiac magnetic resonance are becoming essential for daily practice. In this context, a deep understanding of LA mechanics, its prognostic significance, and the available approaches are essential to improve clinical practice. The present review will focus on LA mechanics, discussing atrial physiology and pathophysiology of main cardiac diseases across the HF stages with specific attention to the prognostic significance. Imaging techniques for LA mechanics assessment will be discussed with an overlook on the dynamic (under stress) evaluation of the chamber.

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Section: La Mechanics In Hf Stagesmentioning

confidence: 73%

Cardiac Imaging for the Assessment of Left Atrial Mechanics Across Heart Failure Stages

Bandera

Mollo

Frigelli

et al. 2022

Front. Cardiovasc. Med.

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“…Compared with the traditional feature-tracking, the fast method demonstrated superior reliability and reproducibility, with a great reduction of analysis time [9]. LA strain derived from this method showed independent prognostic value in ST-segment elevation myocardial infarction and hypertrophic cardiomyopathy [11,12]. Leng et al applied similar method to RA in patients with pulmonary artery hypertension and demonstrated that impaired RA strain reflected RV decompensation and predicted adverse cardiac events [13].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic value of right atrial strain derived from cardiovascular magnetic resonance in non-ischemic dilated cardiomyopathy

Guo

et al. 2022

Journal of Cardiovascular Magnetic Resonance

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Background The value of right atrial (RA) function in cardiovascular diseases is currently limited. This study was to explore the prognostic value of RA strain derived from fast long axis method by cardiovascular magnetic resonance (CMR) in patients with non-ischemic dilated cardiomyopathy (DCM). Methods We prospectively enrolled patients with DCM who underwent CMR from June 2012 to March 2019 and 120 age- and sex-matched healthy subjects. Fast long-axis strain method was performed to assess the RA phasic function including RA reservoir strain, conduit strain, and booster strain. The predefined primary endpoint was all-cause mortality. The composite heart failure (HF) endpoint included HF death, HF readmission, and heart transplantation. Cox regression analysis and Kaplan–Meier survival curve were performed to describe the association between RA strain and outcomes. Results A total of 624 patients (444 men, mean 48 years) were studied. After a median follow-up of 32.5 months, 116 patients (18.6%) experienced all-cause mortality and 205 patients (32.9%) reached composite HF endpoint. RA function was impaired in DCM patients compared with healthy subjects (all P < 0.001). After adjustment for covariates, RA reservoir strain [hazard ratio (HR) (per 5% decrease) 1.19, 95% confidence interval (CI) 1.03–1.37, P = 0.022] and conduit strain [HR (per 5% decrease) 1.37, 95% CI 1.03–1.84, P = 0.033] were independent predictors of all-cause mortality. Moreover, RA strain added incremental prognostic value for the prediction of adverse cardiac events over baseline clinical and CMR predictors (all P < 0.05). Conclusion RA strain by fast long-axis analysis is independently associated with adverse clinical outcomes in patients with DCM. Trial registration: Trial registration number: ChiCTR1800017058; Date of registration: 2018-07-10 (Retrospective registration); URL: https://www.clinicaltrials.gov

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“…LA strain decrease may signify a severe impairment of atrial compensatory ability [39] , which might account for its great prognostic value in some studies. This predictive usefulness has also been shown in hypertrophic cardiomyopathy, where inadequate LA reservoir strain markedly raised the probability of death and the onset or progression of HF [40,41] . In another study, LA dysfunction by TT was a separate predictor of HF development in the asymptomatic general population [42] .…”

Section: Discussionmentioning

confidence: 74%

Diagnostic accuracy of Left atrial function and strain for differentiating between acute and chronic myocardial infarction

Jiang

Yan

Yang

et al. 2022

Preprint

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Background The left atrial strain and strain rate in patients with myocardial infarction (MI) were measured using the cardiac magnetic resonance tissue tracking (CMR-TT) technique, and its usefulness in the quantitative assessment of myocardial infarction for differentiating between acute and chronic myocardial infarction was assessed. Methods Consecutive 36 AMI patients and 29 CMI patients who underwent CMR were retrospectively analyzed as well as 30 controls. By analyzing the strain from long and short left ventricular view cines from CMR-TT, the left atrial and ventricular functions were measured. Receiver operating characteristic(ROC) analysis was used to test the diagnostic accuracy of the CMR-TT strain parameters in distinguishing acute from chronic myocardial infarction. Results Participants in both AMI and CMI demonstrated decreased LA reservoir function, conduit function, and LA booster pump dysfunction as compared to the controls. The LA strain was more sensitive than the LV global strain for determining the stage of MI. Of all the LA strain parameters measured, SRa produced the best areas under the ROC curve (AUC) of 0.879 in demonstrating distinction between acute and chronic myocardial infarction. The LV strain and LA functional parameters showed the largest significant differences between chronic myocardial infarction and normal (P < 0.001, respectively), while there was no difference between AMI and normals. Conclusions CMR-TT-derived LA strain is a promising and robust tool for demonstrating impaired LA mechanics and quantifying LA dynamics, both of which have high sensitivity and specificity in the differential diagnosis of acute versus chronic myocardial infarction, and their use in clinical application is thus worth promoting.

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Prognostic value of fast semi-automated left atrial long-axis strain analysis in hypertrophic cardiomyopathy

Cited by 20 publications

References 27 publications

Cardiac Imaging for the Assessment of Left Atrial Mechanics Across Heart Failure Stages

Cardiac Imaging for the Assessment of Left Atrial Mechanics Across Heart Failure Stages

Prognostic value of right atrial strain derived from cardiovascular magnetic resonance in non-ischemic dilated cardiomyopathy

Diagnostic accuracy of Left atrial function and strain for differentiating between acute and chronic myocardial infarction

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