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The correlation between conventional echocardiography and two‐dimensional speckle strain imaging for evaluating left atrial function in patients with moderate to severe mitral stenosis
Author(s) -
Sahebjam Mohammad,
Montazeri Vahide,
Zoroufian Arezoo,
Hosseinsabet Ali,
LotfiTokaldany Masoumeh,
Jalali Arash
Publication year - 2018
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.14088
Subject(s) - cardiology , medicine , speckle tracking echocardiography , cutoff , sinus rhythm , atrial fibrillation , ejection fraction , stenosis , doppler imaging , diastole , heart failure , blood pressure , physics , quantum mechanics
Aim We intended to assess the left atrial deformation parameters, using two‐dimensional speckle tracking (2 DSTE ) and transesophageal echocardiography ( TEE ), and determine the correlation between these two techniques in order to recognize the patients at risk for cardioembolic events. Method Strain and strain rate were measured using 2 DSTE among 26 patients in sinus rhythm, with isolated moderate to severe mitral stenosis. Left atrial ( LA ) volume parameters (maximum, minimum and preatrial contraction) were measured. Among 26 patients, TEE was performed to detect left atrial thrombosis or spontaneous echo contrast. Left atrial appendage velocity ( LAAV ) was also assessed. Results A significant correlation was observed between LAAV and the average value of left atrial peak systolic strain ( LA ‐ RES ) ( r = 0.638, P = 0.001). The sensitivity and specificity of mean LA ‐ RES (cutoff = 16.75%) for detecting LAAV < 25 cm/s were 88.9% and 80%, respectively. The sensitivity and specificity of mean LA ‐ RES (cutoff = 18.14%) for detecting LAAV < 25 cm/s and/or dense smoky pattern were 77.8% and 83.3%, respectively, and those of left atrial maximum volume indexed for body surface area(cutoff = 50.75 cc/m 2 ), for discriminating LAAV < 25 cm/s and/or dense smoky pattern, were 73.3% and 83.3%, respectively. A meaningful correlation was witnessed between mean LA ‐ RES and left atrial ejection fraction ( r = 0.736, P < 0.001), and left atrial expansion index ( r = 0.743, P < 0.001). Conclusion The average value of left atrial reservoir function using 2 DSTE can be used as a predictive factor for detecting LAAV < 25 cm/s and/or dense SEC and thus recognizing high‐risk patients for cardioembolic events with moderate to severe mitral stenosis. In addition, assessment of LA function and LA volume can also be helpful.