P1388 LA and LV strains are closely linked in patients with diastolic dysfunction and preserved ejection fraction

Abstract

Abstract Introduction Left atrial (LA) strain has been proposed as an independent parameter for the assessment left ventricular (LV) diastolic function. However, there is increasing evidence of impaired LV longitudinal function in patients with diastolic dysfunction(DD) and preserved ejection fraction (EF). Purpose To assess the relationship between LA and LV strain parameters with different grades of LV diastolic dysfunction in patients with preserved EF. Methods We included 95 patients with EF > 50% and good image quality. Patients with a mobile interatrial septum, more than mild valvular regurgitation and previous heart surgery were excluded. Standard echocardiographic measurements and the assessment of the diastolic function were performed according to current guidelines. LA and LV strains were assed using speckle tracking in 4 and 2 chambers apical views, using R-R gating. Strain values from LA and LV strain curves were derived in every phase of the cardiac cycle (peak systolic, early and late diastole strain). Results 26 patients had normal diastolic function, 23 had grade 1, 19 grade 2 and 13 grade 3 DD. Fourteen patients with indeterminate DD grade were excluded. Both peak LA and LV strain decreased significant with the degree of DD (Fig.). LA and LV early diastole strain were significantly higher in patients with normal diastolic function than any degree of DD. LA and LV late diastole strain increased in grade 1 DD. LA and LV strain parameters changes correlated significantly in systole, early and late diastole (r = 0.81,p < 0.0001; r = 0.64, p < 0.0001; r = 0.76, p < 0.0001, respectively). Other standard parameters of DD were not capable to differentiate between grades of DD. Conclusion LA and LV strain parameters show similar changes with increasing diastolic dysfunction. Diastolic dysfunction was regularly associated with reduced longitudinal strain in both LA and LV despite preserved EF. This suggest that both LA or LV strain could be used for the assessment of diastolic function. Abstract P1388 Figure. LA and LV strain parameters by DD