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Left Atrial Dysfunction Assessed by Two‐Dimensional Speckle Tracking Echocardiography in Patients with Impaired Left Ventricular Ejection Fraction and Sleep‐Disordered Breathing
Author(s) -
Miśkowiec Dawid,
Karolina Kupczyńska,
Michalski Błażej W.,
UznańskaLoch Barbara,
Kurpesa Małgorzata,
Kasprzak Jarosław D.,
Lipiec Piotr
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12987
Subject(s) - ejection fraction , cardiology , medicine , speckle tracking echocardiography , ambulatory , diastole , heart failure , blood pressure
Aims To evaluate the relationship between left atrial ( LA ) structure and deformation obtained by two‐dimensional speckle tracking echocardiography (2DSTE): peak longitudinal systolic strain ( LA s), peak longitudinal systolic strain rate ( LAS ‐ SR ), peak longitudinal early diastolic strain rate ( LAE ‐ SR ), peak longitudinal late diastolic strain rate ( LAA ‐ SR ), and sleep‐disordered breathing ( SDB ) estimated by means of apnea–hypopnea index (e AHI ). Methods Thirty‐two individuals with ischemic heart disease ( IHD ) and impaired left ventricular ejection fraction ( EF < 50%) were included in the study. LA function was assessed using 2DSTE. e AHI index was calculated by means of the 24‐hour ambulatory H olter electrocardiogram monitoring. Patients were categorized into two subgroups: SDB group (e AHI ≥ 15; n = 15) and non‐ SDB group (e AHI < 15; n = 17). Results All 2DSTE parameters were decreased in the SDB group: LAS ‐ SR (0.90 [0.60–1.25] 1/sec vs. 1.25 [1.00–1.27] 1/sec, P = 0.043), LAE ‐ SR (−0.76 ± 0.49 1/sec vs. −1.18 ± 0.55 1/sec, P = 0.033), and LAA ‐ SR (−1.26 ± 0.71 1/sec vs. −1.48 ± 0.75 1/sec, P = 0.049). The e AHI was negatively correlated with LA reservoir function: LAS (r = −0.53, P = 0.002) and LAS ‐ SR (r = −0.47, P = 0.006), while it is positively correlated with LAE ‐ SR (r = 0.67, P < 0.001) and LAA ‐ SR (r = 0.46, P = 0.009). Moreover, SDB severity was an independent predictor of impaired LA compliance (P = 0.016) and conduit function (P = 0.002) in multivariate linear regression model, even after adjustment for age, BMI , gender, LV systolic ( EF ), and diastolic ( E /e′) function and comorbidities. Conclusions LA dysfunction and remodeling assessed using 2DSTE in patients with impaired systolic LV function, and IHD is influenced by the severity of sleep apnea independently from LV function.