The Egyptian Heart Journal (Sep 2016)

Left atrial myocardial deformation characteristics in patients presenting with ST elevation myocardial infarction

  • Gehan Magdy,
  • Hesham El Ashmawy,
  • Ali Zidan,
  • Abdulkarem Saeed

DOI
https://doi.org/10.1016/j.ehj.2016.05.003
Journal volume & issue
Vol. 68, no. 3
pp. 181 – 186

Abstract

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Background: The left atrium (LA) plays an important role in left ventricular (LV) function, we investigated the LA myocardial deformation characteristics in patients presenting with acute ST segment elevation myocardial infarction (STEMI). Methods: Forty STEMI patients (aged 54.78 ± 6.7, 92.5% men) and twenty healthy matched control (aged 50.7 ± 7.4 years, 90% men) were included. All patients had conventional echocardiography and tissue Doppler imaging (TDI), with measurement of LA volumes (LA maximum volume index, LA minimum volume index, and LA reservoir volume index), the early transmitral inflow velocity (E) to early diastolic mitral annular velocity (Ea) ratio, and the LA global longitudinal strain and strain rate were also measured using TDI, and the following parameters were measured: the global [peak systolic strain (PSS), peak systolic strain rate (PSSR), early diastolic strain rate (ESR), and late diastolic strain rate (ASR)]. Results: All the measured LA volumes were significantly increased in patients compared to control. The LA global longitudinal strain (%) and strain rate (S−1) parameters were significantly reduced in patients compared to control, the PSS (11.69 ± 4.25 vs 22.43 ± 3.74, p = 0.0001), the PSSR (1.04 ± 0.37 vs 1.81 ± 0.28, p = 0.0001), the ESR (−0.84 ± 0.44 vs −1.98 ± 0.60, p = 0.0001), and the ASR (−1.43 ± 0.29 vs −1.62 ± 0.37, p = 0.034), and we found that the global PSS had a significant negative correlation to E/Ea (r = −0.457, P = 0.0001) and significant positive correlation to left ventricular ejection fraction (r = 0.338, P = 0.033) in patients with STEMI. Conclusion: Our study concluded that the LA reservoir, conduit and booster pump functions studied by TDI strain were reduced in STEMI patients, and the global peak systolic strain was significantly correlated with the LV systolic and diastolic dysfunction.

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