Evaluation of Left Atrial Dysfunction by Speckle Tracking
Echocardiography in Systolic and Diastolic Heart Failure.
Abstract
Aim: to assess and evaluate the Left Atrial (LA) dysfunction by
two-dimensional speckle tracking echocardiography (2DSTE) in patients
with diastolic heart failure (DHF) and systolic heart failure (SHF).
Materials and methods: The study included 74 patients with DHF, 26
patients with SHF, and 50 normal matched subjects. The LA phasic
functions, LA volume index and E/e~ were evaluated by
conventional echocardiography.The2DSTE used to evaluate both the left
ventricular global strain (LVGS) and The Left Atrial Global Strain
(LAGS) and reevaluate the LA phasic functions through Peak-atrial
longitudinal strain (PALS), peak-atrial contraction strain (PACS), and
PALS-PACS which reflecting LA reservoir, pump, and conduit function,
respectively. Results: The LVGS was -19.54±1.42 % in controls,
-18.66±1.15 % in DHF and -14.72±1.97 % in SHF (P-value
<0.0001); LAGS was 52.62±6 %in controls,37.86±4.59 in DHF and
21±5.37 in SHF (P-value <0.0001); The PALS was 49.9±4.83 in
controls, 33.26 ±4.82 in DHF and 19.69±5.55 in SHF(P-value
was<0.0001);The PACS was 20.19±2.25 in controls, 12.47±2.29 in
DHF and 8.35±2.71 in SHF (P-value <0.0001); The PALS-PACS
was29.57±4.02 in controls, 20.76±3.8 in DHF and 11.35±3.14 in SHF
(p-value <0.0001). Conclusion: LA phasic function was worse in
SHF compared with those with DHF. Early LA dysfunction in Heart failure
can be detected accurately and easily by speckle tracking technique more
than conventional echocardiography suggesting that The LA myocardial
deformation analysis by 2-D STE could be a promising tool to better
understand of heart failure and its classification. Key words: Speckle
tracking; systolic heart failure; diastolic heart failure; left atrial
dysfunction.