The differences in left atrial function between ischemic and idiopathic dilated cardiomyopathy patients: A two-dimensional speckle tracking imaging study.

To evaluate left atrial (LA) function in patients with ischemic (ICM) or idiopathic dilated (DCM) cardiomyopathy via two-dimensional speckle-tracking imaging. We measured the LA maximum volume, minimum volume, and volume before the atrial systole, and calculated total emptying volume, expansion index, active emptying volume, and fraction. We measured strain and strain rate during systole and late diastole using two-dimensional speckle-tracking imaging, and analyzed correlations between variables. We found no significant differences in LA size, left ventricle (LV) end-diastole diameter, LV ejection fraction (EF), E/A, E/e', deceleration time of the E wave, and effective mitral regurgitant orifice area between the DCM and the ICM group. However, the LA expansion index, active EF, systolic and late diastolic strain, and strain rate were lower in the ICM group (p < 0.05). The expansion index and active EF were positively correlated with the systolic strain rate and the absolute value of the late diastolic strain rate, respectively. LA basic echocardiographic variables did not reflect the differences between ICM and DCM patients, but the systolic and late diastolic strain, as well as the strain rate, were lower in DCM patients. Two-dimensional speckle-tracking imaging is a promising method to differentiate these patients. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:437-445, 2016.

Cao S ，Zhou Q ，Chen JL ，Hu B ，Guo RQ ... -  《-》

Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: a two-dimensional speckle strain study.

D'Andrea A ，Caso P ，Romano S ，Scarafile R ，Cuomo S ，Salerno G ，Riegler L ，Limongelli G ，Di Salvo G ，Romano M ，Liccardo B ，Iengo R ，Ascione L ，Del Viscovo L ，Calabrò P ，Calabrò R ... -  《-》

Different effects of cardiac resynchronization therapy on left atrial function in patients with either idiopathic or ischaemic dilated cardiomyopathy: a two-dimensional speckle strain study.

D'Andrea A ，Caso P ，Romano S ，Scarafile R ，Riegler L ，Salerno G ，Limongelli G ，Di Salvo G ，Calabrò P ，Del Viscovo L ，Romano G ，Maiello C ，Santangelo L ，Severino S ，Cuomo S ，Cotrufo M ，Calabrò R ... -  《EUROPEAN HEART JOURNAL》

An assessment of left atrial function in patients with hypertrophic obstructive cardiomyopathy before and 1 year after septal ablation by two-dimensional speckle tracking echocardiography.

The objective of this study was to assess left atrial (LA) function with two-dimensional speckle tracking echocardiography (2DSTE) in addition to standard echocardiographic assessments in patients with hypertrophic obstructive cardiomyopathy (HOCM) before and 1 year after septal ablation (SA). The study included 31 patients with HOCM, who underwent SA. Each patient with HOCM underwent a complete two-dimensional transthoracic echocardiography before and 1 year after the SA. The measurements included basal septal thickness, left ventricular outflow trace (LVOT) gradient, mitral regurgitation (MR) grade, LA dimensions, left ventricular (LV) ejection fraction, and tissue Doppler parameters of lateral mitral annular e' and septal mitral annular e'. The LA wall was tracked on a frame-by-frame basis using 2DSTE, and LA volume waveforms were generated. The maximum LA volume (LAVmax ), minimal LA volume (LAVmin ), and the LA volume before atrial contraction (LAVpre-a ) were measured. The LA reservoir function was calculated as the expansion index and diastolic emptying index. The LA conduit function was calculated as the passive emptying percentage of total emptying (PE) and the passive emptying index (PEI). The LA booster function was calculated as the active emptying percentage of total emptying (AE) and the active emptying index (AEI). The LVOT gradient, end-diastolic septal base thickness, the grade of MR, and LA end-diastolic size were significantly decreased in patients with HOCM before and 1 year after the SA (All P<.05). The lateral mitral annular e' was significantly increased (P<.05), and the E/lateral e' ratio was significantly decreased (P<.05), whereas septal mitral annular e' was significantly decreased (P<.05), and the E/septal e' ratio was significantly increased (P<.05). LAVImax , LAVImin , and LAVIpre-a were significantly decreased 1 year after the SA (All P<.05). The expansion and diastolic emptying indices were significantly increased (All P<.05) at 1 year after the SA. PE and PEI were significantly increased (All P<.05). The AE and AEI were significantly decreased (All P<.05). LAVImax , LAVImin , and LAVIpre-a of the responders group were significantly lower than those of the nonresponders group (All P<.05). The expansion and diastolic emptying indices of the responders group were significantly higher than those of the nonresponders group (All P<.05). The PE and PEI of the responders were significantly higher than those of the nonresponders group (All P<.05). The AE and AEI of the responders were significantly lower than those of the nonresponders group (All P<.05). We found an improvement in the LA reservoir and conduit function but a reduction in LA booster pump function 1 year after the SA in the responders.

Fang H ，Tang H ，Li P ，Xiong L ，Hu G ，Li L ，Yu Y ，Zhao B ... -  《-》

Preliminary observations of prognostic value of left atrial functional reserve during dobutamine infusion in patients with dilated cardiomyopathy.

The importance of left atrial (LA) functional reserve in patients with depressed left ventricular function remains unclear. Thus, the aim of this study was to test the hypothesis that diminished augmentation of LA function during dobutamine stress might be associated with cardiovascular events in patients with dilated cardiomyopathy. Eighty-four patients with dilated cardiomyopathy with a mean ejection fraction of 34 ± 9% were retrospectively recruited, and LA strain was determined as the averaged global speckle-tracking longitudinal strain from apical four-chamber and two-chamber views during dobutamine stress (20 μg/kg/min). The systolic component of LA strain was considered to reflect reservoir function, whereas the passive and active emptying components were considered to reflect passive and active emptying function, respectively. Event-free survival was tracked for 17 months. Multivariate Cox proportional-hazards analysis identified LA volume index (hazard ratio [HR], 1.060; P < .001) and β-blocker use (HR, 0.048; P < .05) as the independent variables associated with cardiovascular events among the baseline parameters and changes in systolic LA strain (HR, 0.971; P = .02), in passive emptying LA strain (HR, 0.942; P < .001), and in left ventricular early diastolic strain rate (HR, 0.986; P = .03) under dobutamine as the variables among the functional reserve parameters. In sequential Cox models, a model based on clinical variables (χ(2) = 9.3) was improved by conventional echocardiographic parameters (χ(2) = 19.2, P = .012) and LA strain parameters at rest (χ(2) = 40.1, P = .005) and further improved by the addition of changes in LA strain parameters under dobutamine (χ(2) = 61.6, P < .001). The assessment of LA reservoir and passive emptying function during dobutamine stress provides important incremental prognostic value in patients with dilated cardiomyopathy.

Matsumoto K ，Tanaka H ，Imanishi J ，Tatsumi K ，Motoji Y ，Miyoshi T ，Onishi T ，Kawai H ，Hirata K ... -  《-》