Abstract 15077: Left Atrial Endocardial Surface Area Strain Assessed by 3-Dimensional Speckle Tracking Imaging is a Useful Method in Assessing Left Ventricular End-Diastolic Pressure
Background: Some previous studies reported that elevated left atrial (LA) pressure deteriorates LA wall distensibility. A novel 3-dimensional ultrasound speckle tracking imaging (3D-STI) technique enables us to evaluate LA endocardial surface area deformation, which is named area strain. Accordingly, we investigated whether LV end-diastolic pressure (LVEDP) could be predicted by measuring LA area strain.
Methods: Study subjects were consecutive 30 patients with sinus rhythm who underwent diagnostic cardiac catheterization and 3D-STI (Artida, Toshiba) on the same day. Five of them had prior myocardial infarction, while the remaining 25 had no localized LV wall motion abnormality. The temporal changes of LA area strain from LV end-diastole to end-systole were drawn offline using an echo image analyzer (Ultra-Extend, Toshiba). The peak area strain at LV end-systole and the area strain value just before LA contraction were measured. LV pressure was obtained using a catheter-tipped micromanometer. From the recorded pressure waves, we computed mean LV pressure during diastole (m-LVDP) and LVEDP.
Results: The peak area strain at LV end-systole had significant correlations with both the m-LVDP (r=-0.65, p<0.001) and the LVEDP (r=-0.70, p<0.0001). Furthermore, the area strain value just before atrial contraction had much closer correlations with both the m-LVDP (r=-0.74, p<0.0001) and with the LVEDP (r=-0.76, p<0.0001).
Conclusions: This study indicates that LV stiffness can be assessed with LA endocardial surface area strain obtained using 3D-STI. LA wall area strain is a new useful parameter for noninvasive prediction of m-LVDP and LVEDP.
- © 2011 by American Heart Association, Inc.