Assessment of left atrial deformation properties by speckle tracking in patients with systolic heart failure

Abstract

Objectives: To evaluate left atrial (LA) function using speckle tracking based strain (SPTS) in systolic heart failure (SHF) patients. Background: LA changes occur in patients with SHF and LA enlargement is commonly found by echocardiography. New speckle tracking based strain can be used to detect left atrial changes in SHF. Materials and methods: Forty patients with clinical (SHF), EF < 40%, NYHA class II-IV and normal sinus rhythm were compared with twenty-five age and sex matched healthy controls. Conventional echo was done where the LV dimensions, volumes, EF, wall thickness & LA diameter were measured. LA total emptying, passive and active volumes & fractions were calculated in both apical 4 & 2 chamber views. Peak atrial longitudinal strain (PALS), Peak atrial contraction strain (PACS), LA strain at the end of LA contraction (Post-A strain) and LA contraction systolic index (LA CSI) were calculated from each LA wall. LV global strain (LVGS) was measured in apical 4, 2 and 3 chamber views and was averaged. Results: SHF patients had significantly higher LA diameter volumes but lower LA fractions, Also, there were significantly lower LA PALS, PACS, Post-A and higher LA CSI, however, the LA strain parameters were negatively correlated with the NYHA class and positively correlated with LV global strain. Conclusion: In patients with SHF, LA function is significantly reduced. Moreover, LA reservoir & booster pump function correlate negatively with heart failure symptoms and positively with LV global strain.

Keywords

• Heart failure
• Left atrium
• Speckle tracking strain