Abstract 8551: Left Atrial Strain by Speckle Tracking Echocardiography In Patients with Heart Failure - An Independent and Incremental Predictor of Cardiac Death or Need of Heart Transplantation
Background: We have recently shown that left atrial (LA) stretching during atrial filling, measured as peak LA strain by speckle tracking echocardiography (STE), is a strong and independent predictor of cardiac death or heart transplantation (HTx) in patients with heart failure (HF). Furthermore, our study demonstrated that while logNT-proBNP and left ventricular ejection fraction (LVEF) were independent predictors of these end points, age, LA area and E/e’ were not. In the present study we investigate if LA strain adds predictive power to that provided by NT-proBNP and LVEF.
Methods: We included 143 patients (age 54±11 years), with ischemic or dilated cardiomyopathy (NYHA II-IV, LVEF= 31±13%). Peak LA strain by STE and LVEF were measured. Time to death or HTx (Cox model) was adjusted for age, logNT-proBNP and LVEF in addition to LA strain. We computed receiver-operating characteristic (ROC) curves and tested for equality of the areas under the curve (AUC) for models with and without LA strain.
Results: Median follow-up time was 3.0 years. There were 39 events and median time to event was 0.7 years (range 0.1 to 4.3). LVEF (P=0.008), logNT-proBNP (P=0.007) and LA strain (P=0.007) were independent predictors of cardiac events. When LA strain was added to age, LVEF and logNT-proBNP, AUC demonstrated significantly better predictive power (0.68±0.05 vs. 0.73±0.05, P=0.048; Figure 1).
Conclusion: LA strain by STE is an independent and incremental predictor of death or need of HTx in patients with moderate to severe HF. This finding suggests that LA strain by STE may serve as a marker in the risk stratification of patients with HF.
- © 2011 by American Heart Association, Inc.