Abstract 16162: Left Atrial Deformation at Rest Predicts Peak Exercise Pulmonary Artery Wedge Pressure and Mean Pulmonary Artery Pressure
Introduction: Impaired left atrial (LA) function may contribute to exertional limitation. LA strain (LAS), is a novel echocardiographic measure of LA function, but its relationship to the hemodynamic response to exercise is not known.
Hypothesis: Resting LAS is association with invasively-assessed peak exercise pulmonary artery wedge pressure (PAWP) and mean pulmonary artery pressure (MPAP).
Methods: 68 patients ≥45 years old referred for evaluation of dyspnea underwent rest echocardiography followed by exercise testing with invasive hemodynamic monitoring. Patients with ≥moderate mitral valvular disease were excluded. LAS was measured by 2D speckle-tracking.
Results: Mean age was 64±11 years, 31% were male, 58% had hypertension, 13% had diabetes, mean LVEF was 61±8%, and mean LAS was 33± 9%. Worse LAS was associated with older age, greater LA volume, higher LV mass, lower LV diastolic relaxation velocities (e’), worse LV longitudinal strain, higher PAWP/LVEDV ratio, and higher MPAP (all p<0.04). With excise, peak VO2 and cardiac output did not vary with LAS. However, even after adjusting for age, sex, and peak VO2, worse LAS at rest was associated with higher peak exercise PAWP and MPAP (Figure). These associations were no longer significant after further adjusting for LA volume and measures of LV structure and function (LV mass, e’, and longitudinal strain; p=0.68).
Conclusion: Worse resting LAS is associated with worse LV compliance and longitudinal function. Impaired resting LAS predicts exercise-associated peak PAWP and MPAP, but concomitant abnormalities of LV function appear to account for these associations.
- Atrial function
- Cardiopulmonary exercise testing
- Myocardial contraction
- Exercise tests and training
Author Disclosures: T. Biering-Sørensen: None. M. Santos: None. J. Rivero: None. E. West: None. A.R. Opotowsky: None. A.B. Waxman: None. D.M. Systrom: None. A.M. Shah: None.
- © 2016 by American Heart Association, Inc.