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Morrone D, Arbucci R, Wierzbowska-Drabik K, Ciampi Q, Peteiro J, Agoston G, Varga A, Camarozano AC, Boshchenko A, Ryabova T, Dekleva M, Simova I, Lowenstein Haber DM, Tesic M, Boskovic N, Djordjevic-Dikic A, Beleslin B, D'Alfonso MG, Mori F, Rodrìguez-Zanella H, Kasprzak JD, Cortigiani L, Lattanzi F, Scali MC, Torres MAR, Daros CB, de Castro E Silva Pretto JL, Gaibazzi N, Zagatina A, Zhuravskaya N, Amor M, Mieles PEV, Merlo PM, Monte I, D'Andrea A, Re F, Di Salvo G, Merli E, Lorenzoni V, De Nes M, Paterni M, Limongelli G, Prota C, Citro R, Colonna P, Villari B, Antonini-Canterin F, Carpeggiani C, Lowenstein J, Picano E. Feasibility and functional correlates of left atrial volume changes during stress echocardiography in chronic coronary syndromes. Int J Cardiovasc Imaging 2020; 37:953-964. [PMID: 33057991 DOI: 10.1007/s10554-020-02071-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
An enlarged left atrial volume index (LAVI) at rest mirrors increased LA pressure and/or impairment of LA function. A cardiovascular stress may acutely modify left atrial volume (LAV) within minutes. Aim of this study was to assess the feasibility and functional correlates of LAV-stress echocardiography (SE) Out of 514 subjects referred to 10 quality-controlled labs, LAV-SE was completed in 490 (359 male, age 67 ± 12 years) with suspected or known chronic coronary syndromes (n = 462) or asymptomatic controls (n = 28). The utilized stress was exercise in 177, vasodilator in 167, dobutamine in 146. LAV was measured with the biplane disk summation method. SE was performed with the ABCDE protocol. The intra-observer and inter-observer LAV variability were 5% and 8%, respectively. ∆-LAVI changes (stress-rest) were negatively correlated with resting LAVI (r = - 0.271, p < 0.001) and heart rate reserve (r = -.239, p < 0.001). LAV-dilators were defined as those with stress-rest increase ≥ 6.8 ml/m2, a cutoff derived from a calculated reference change value above the biological, analytical and observer variability of LAVI. LAV dilation occurred in 56 patients (11%), more frequently with exercise (16%) and dipyridamole (13%) compared to dobutamine (4%, p < 0.01). At multivariable logistic regression analysis, B-lines ≥ 2 (OR: 2.586, 95% CI = 1.1293-5.169, p = 0.007) and abnormal contractile reserve (OR: 2.207, 95% CI = 1.111-4.386, p = 0.024) were associated with LAV dilation. In conclusion, LAV-SE is feasible with high success rate and low variability in patients with chronic coronary syndromes. LAV dilation is more likely with reduced left ventricular contractile reserve and pulmonary congestion.
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Affiliation(s)
| | - Rosina Arbucci
- Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina
| | | | - Quirino Ciampi
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Jesus Peteiro
- CHUAC- Complexo Hospitalario Universitario A Coruna- University of A Coruna, La Coruna, Spain
| | - Gergely Agoston
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Albert Varga
- Institute of Family Medicine, University of Szeged, Szeged, Hungary
| | - Ana Cristina Camarozano
- Hospital de Clinicas UFPR, Medicine Department, Federal University of Paranà, Curitiba, Brazil
| | - Alla Boshchenko
- Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation
| | - Tamara Ryabova
- Cardiology Research Institute, Tomsk National Research Medical Centre of the Russian Academy of Sciences, Tomsk, Russian Federation
| | - Milica Dekleva
- Clinical Cardiology Department, Clinical Hospital Zvezdara, Medical School, University of Belgrade, Belgrade, Serbia
| | - Iana Simova
- Head of Cardiology Department, Acibadem City Clinic Cardiovascular Center, University Hospital, Sofia, Bulgaria
| | | | - Milorad Tesic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Nikola Boskovic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Ana Djordjevic-Dikic
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Branko Beleslin
- Cardiology Clinic, Clinical Center of Serbia, Medical School, University of Belgrade, Belgrade, Serbia
| | - Maria Grazia D'Alfonso
- SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, Firenze, Italy
| | - Fabio Mori
- SOD Diagnostica Cardiovascolare, DAI Cardio-Toraco-Vascolare, Azienda Ospedaliera-Universitaria Careggi, Firenze, Italy
| | | | | | | | - Fabio Lattanzi
- Cardiothoracic Department, University of Pisa, Pisa, Italy
| | | | - Marco A R Torres
- Hospital de Clinicas de Porto Alegre - Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | | | | | - Nicola Gaibazzi
- Cardiology Department, Parma University Hospital, Parma, Italy
| | - Angela Zagatina
- Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, St Petersburg, Russian Federation
| | - Nadezhda Zhuravskaya
- Cardiology Department, Saint Petersburg State University Clinic, Saint Petersburg State University, St Petersburg, Russian Federation
| | - Miguel Amor
- Cardiology Department, Ramos Mejia Hospital, Buenos Aires, Argentina
| | | | | | - Ines Monte
- Echocardiography Lab, Cardio-Thorax-Vascular Department, "Policlinico Vittorio Emanuele", Catania University, Catania, Italy
| | | | - Federica Re
- Cardiology Division, Ospedale San Camillo, Rome, Italy
| | - Giovanni Di Salvo
- Cardiology Division, Pediatric Cardiology Department, Brompton Hospital, Imperial College of London, London, UK
| | - Elisa Merli
- Department of Cardiology, Ospedale per gli Infermi, Faenza, Ravenna, Italy
| | | | - Michele De Nes
- Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Marco Paterni
- Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy
| | | | - Costantina Prota
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Rodolfo Citro
- Cardiology Department and Echocardiography Lab, University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno, Italy.,Italian Society of Echocardiography and Cardiovascular Imaging, Rome, Italy
| | - Paolo Colonna
- Italian Society of Echocardiography and Cardiovascular Imaging, Rome, Italy.,Cardiology Hospital, Policlinico University Hospital of Bari, Bari, Italy
| | - Bruno Villari
- Cardiology Division, Fatebenefratelli Hospital, Benevento, Italy
| | - Francesco Antonini-Canterin
- Italian Society of Echocardiography and Cardiovascular Imaging, Rome, Italy.,Cardiac Prevention and Rehabilitation Unit, Highly Specialized Rehabilitation Hospital Motta Di Livenza, Treviso, Italy
| | - Clara Carpeggiani
- Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy
| | - Jorge Lowenstein
- Cardiodiagnosticos, Investigaciones Medicas, Buenos Aires, Argentina
| | - Eugenio Picano
- Biomedicine Department, Institute of Clinical Physiology, CNR, Pisa, Italy.
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Cao S, Zhou Q, Chen JL, Hu B, Guo RQ. The differences in left atrial function between ischemic and idiopathic dilated cardiomyopathy patients: A two-dimensional speckle tracking imaging study. JOURNAL OF CLINICAL ULTRASOUND : JCU 2016; 44:437-445. [PMID: 26990443 DOI: 10.1002/jcu.22352] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 02/01/2016] [Accepted: 02/08/2016] [Indexed: 06/05/2023]
Abstract
PURPOSE To evaluate left atrial (LA) function in patients with ischemic (ICM) or idiopathic dilated (DCM) cardiomyopathy via two-dimensional speckle-tracking imaging. METHODS We measured the LA maximum volume, minimum volume, and volume before the atrial systole, and calculated total emptying volume, expansion index, active emptying volume, and fraction. We measured strain and strain rate during systole and late diastole using two-dimensional speckle-tracking imaging, and analyzed correlations between variables. RESULTS We found no significant differences in LA size, left ventricle (LV) end-diastole diameter, LV ejection fraction (EF), E/A, E/e', deceleration time of the E wave, and effective mitral regurgitant orifice area between the DCM and the ICM group. However, the LA expansion index, active EF, systolic and late diastolic strain, and strain rate were lower in the ICM group (p < 0.05). The expansion index and active EF were positively correlated with the systolic strain rate and the absolute value of the late diastolic strain rate, respectively. CONCLUSIONS LA basic echocardiographic variables did not reflect the differences between ICM and DCM patients, but the systolic and late diastolic strain, as well as the strain rate, were lower in DCM patients. Two-dimensional speckle-tracking imaging is a promising method to differentiate these patients. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:437-445, 2016.
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Affiliation(s)
- Sheng Cao
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Qing Zhou
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jin-Ling Chen
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Bo Hu
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Rui-Qiang Guo
- Department of Ultrasonography, Renmin Hospital of Wuhan University, Wuhan 430060, China
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Shen J, Zhou Q, Liu Y, Luo R, Tan B, Li G. Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography. Cardiovasc Ultrasound 2016; 14:34. [PMID: 27550185 PMCID: PMC4994319 DOI: 10.1186/s12947-016-0078-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 08/17/2016] [Indexed: 01/09/2023] Open
Abstract
Background Iron-deficiency anemia (IDA) is a global health problem and a common medical condition that can be seen in everyday clinical practice. And two-dimensional speckle tracking echocardiography (2D-STE) has been reported very useful in evaluating left atrial (LA) function, as well as left ventricular (LV) function. The aim of our study is to evaluate the LA function in patients with IDA by 2D-STE. Methods 65 patients with IDA were selected. This group of patients was then divided into two groups according to the degree of hemoglobin: group B (Hb > 90 g/L) and group C (Hb60 ~ 90 g/L). Another 30 healthy people were also selected as control group A. Conventional echocardiography parameters, such as left atrial diameter (LAD), peak E and A of mitralis (E, A), E/A, end-diastolic thickness of ventricular septum (IVST d), end-diastolic thickness of LV posterior wall (PWTd) and left ventricular end-diastolic dimension (LVDd) were obtained from these three groups. Left atrial minimum volume (LAVmin), left atrial pre-atrial contraction volume (LAVp) and left atrial maximum volume (LAVmax) were measured by Simpson’s rule, whereas left atrial active ejection fraction (LAAEF) and left atrial passive ejection fraction (LAPEF) were obtained from calculation. Two-dimensional images were acquired from apical four-chamber view and two-chamber view to store images for offline analysis. The global peak atrial longitudinal strain and strain rate of systolic LV (GLSs, GLSRs) as well as early and late diastolic LV strain rate (GLSRe, GLSRa) curves of LA were acquired in each LA segment from basal segment to top segment of LA by 2D-STE. Results Compared with group A, there were no differences between group B and group A (all P > 0.05). The LAAEF and GLSRa were significantly higher in group C compared with those of group A and group B (all P < 0.01). The LAPEF, GLSs, GLSRs and GLSRe were significantly lower in group C compared with those of group A and group B (all P < 0.01). Conclusions 2D-STE could evaluate the LA function in patients with IDA.
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Affiliation(s)
- Jiaqi Shen
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Qiao Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Yue Liu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Runlan Luo
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Bijun Tan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, 116027, China.
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Osuga T, Nakamura K, Morita T, Lim SY, Yokoyama N, Morishita K, Ohta H, Takiguchi M. Effects of various cardiovascular drugs on indices obtained with two-dimensional speckle tracking echocardiography of the left atrium and time-left atrial area curve analysis in healthy dogs. Am J Vet Res 2016. [PMID: 26207968 DOI: 10.2460/ajvr.76.8.702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effects of dobutamine, esmolol, milrinone, and phenylephrine on left atrial phasic function of healthy dogs. ANIMALS 9 healthy Beagles. PROCEDURES Following sedation with propofol on each of 4 experimental days, dogs were administered a constant rate infusion of dobutamine (5 μg/kg/min), esmolol (500 μg/kg/min), milrinone (25 μg/kg, IV bolus, followed by 0.5 μg/kg/min), or phenylephrine (2 μg/kg/min). There was at least a 14-day interval between experimental days. Each drug was administered to 6 dogs. Conventional and 2-D speckle tracking echocardiography were performed before (baseline) and after administration of the cardiovascular drug, and time-left atrial area curves were derived to calculate indices for left atrial reservoir, conduit, and booster pump functions (left atrial phasic function) and left ventricular contractility and lusitropy. RESULTS Compared with baseline values, indices for left atrial reservoir and booster pump functions and left ventricular contractility and lusitropy were significantly increased following dobutamine administration; indices for left atrial phasic function and left ventricular lusitropy were changed insignificantly, and indices for left ventricular contractility were significantly impaired following esmolol administration; indices for left atrial phasic function and left ventricular relaxation were changed insignificantly, and indices for left ventricular systolic function were significantly augmented following milrinone administration; and indices for left atrial phasic function and left ventricular lusitropy were changed insignificantly, and indices of ventricular contractility were significantly impaired following phenylephrine administration. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that, following administration of dobutamine, esmolol, milrinone, or phenylephrine to healthy dogs, left atrial phasic function indices were fairly stable and did not parallel changes in left ventricular function indices.
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