Relationship between LA Strain by 2D Speckle Tracking and LV Diastolic Function in Patient with Different Grades of LV Diastolic Dysfunction

Abstract

Background: Diastolic function assessment is complex and multipara metric because most conventional parameters do not follow the progression of diastolic dysfunction (DD). Strain imaging is an emerging index of LA function, with recent data demonstrating that LA strain is diminished in diastolic heart failure. However, LA strain is not part of the standard assessment of diastolic function. We hypothesized that LA strain decreases with worsening DD in a stepwise fashion and could thus be useful in evaluating DD. Objectives: The aim of the current work was to observe the relationship between left atrial (LA) strain and left ventricular diastolic function. In addition to determine whether LA strain could be used to detect diastolic dysfunction (DD) and classify its degree when present. Patients and Methods: This prospective study included a total of 60 patients with diastolic dysfunction and 20 healthy control individuals, attending at outpatient clinic and Echocardiography Laboratory, Cardiology Department, Al-Hussein University Hospital. They were subjected to detailed echocardiographic examinations of the LV systolic and diastolic function and Lt atrial strain by 2D speckle tracking. Results: There were statistically highly significant differences between the four groups as regard results of GLS strain (P value=0.001) and peak LA strain (P value=0.001). Conclusions: It could be concluded that LA strain measurements are feasible and allow accurate categorization of DD, because unlike the traditional parameters, it changes progressively with severity of DD. LA strain may become a useful tool for diastolic assessment in future clinical practice.