Abstract 10992: Relation of Left Ventricular End-Diastolic Pressure and Pro-BNP Level with Left Atrial Deformation Parameters
Background: It has been shown that speckle tracking echocardiography (STE) is a feasible and reproducible method for assessing left atrial (LA) function. The relation between LV end-diastolic pressure and BNP with LA deformation parameters has not been studied comprehensively. Therefore, we propose to investigate the effects of invasively obtained LV end-diastolic pressure and BNP level on LA deformation parameters.
Methods: The study population consisted of 62 patients who underwent cardiac catheterization for different reasons, such as coronary artery disease and heart failure. All patients underwent a left atrial speckle tracing echocardiography, and their left atrial volumetric measurements were taken. In STE analysis for LA, the peak LA strain at the end of the ventricular systole (LAs-Strain) and the LA strain with LA contraction (LAa-Strain) were obtained.
Results: The univariate correlation analysis demonstrated that the LAs-strain and LAa-strain had a perfect inverse correlation with LVEDP; however, the LAs-strain and LAa-strain only had a moderate correlation with Pro-BNP. Moreover, these correlations were significantly present in low and normal EF groups. The area under the ROC curve of the LAs-Strain was 0.96 (p<0.001) and for the LAa-Strain the area was 0.88 (p<0.001). The best cut-off values of the LAs-Strain and the LAa-Strain for predicting LVEDP were 31.2 and 14.2, respectively. An LAs-Strain lower than 31.2 has a sensitivity of 88.2% and a specificity of 92%. An LAa-Strain lower than 14.2 has a sensitivity of 82.3% and a specificity of 96%. A multiple regression analysis demonstrated that the LAs-Strain, LAVmax and LV-EF were independent predictors of increased LVEDP; however, the LAa-Strain and LV mass index were not independent predictors. A borderline statistical significance was found for Pro-BNP.
Conclusion: The LAs strain is more closely related with LVEDP and the pro-BNP level than the LAa strain. Moreover, a decreased LAs-Strain is an independent predictor of increased LVEDP. An LAs strain <31.2 could possibly predict LVEDP>16 mmHg as a result of its 88.2% sensitivity and 92% specificity.
- © 2011 by American Heart Association, Inc.