Assessment of left atrial function in patients with ischemic and nonischemic dilated cardiomyopathy using speckle-tracking echocardiography

Abstract

Objective The aim was to assess left atrial (LA) function in patients with ischemic and nonischemic dilated cardiomyopathy using speckle tracking echocardiography. Background LA changes occur in patients with dilated cardiomyopathy and LA enlargement is commonly found by echocardiography. Two-dimensional speckle tracking echocardiography is a tool for the evaluation of LA function. Patients and methods This casecontrol study was conducted on 67 randomly selected individuals who presented to the Cardiology Department of Faculty of Medicine, Menoufia University, Egypt, during the period from January 2017 to December 2017. They included 52 patients with systolic heart failure (HF) and 15 normal individuals. In this study, the LA maximum, minimum volumes, and volume before the atrial systole, and calculated total emptying, active emptying volumes, expansion index, and fraction were measured. Strains and strain rates during left ventricular (LV) systole and late LV diastole using speckle-tracking imaging were measured. Results The study showed no significant differences between the nonischemic dilated cardiomyopathy (NIDCM) and ischemic dilated cardiomyopathy (IDCM) groups in the A peak, DT, septal e′, E/A, E/e′ and LAD, LVEDD. LA maximum volume (LAVmax) and the active emptying volume of LA (LAEV) showed no significant difference between the studied groups, but the total emptying capacity of the LA (LATV), the left atrial expansion index, and the left atrial active ejection fraction (LAAEF) were significantly lower in the NIDCM group. The LA strain and strain rate during LV systole (Ss, SRs) and during late LV diastole (Sa, SRa) representing the reservoir and booster pump function of the LA, respectively, were significantly lower in the NIDCM group. Conclusion LA systolic and late diastolic strains and strain rates were significantly lower in NIDCM patients. The LA dynamic reservoir and booster pump function were more severely impaired in NIDCM.