Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study

Abstract Background Left atrial (LA) size is often used as a surrogate marker of LA function in clinical practice, with larger atrial thought to represent a “dysfunctioning” atrium, since there is no accepted ‘gold’ standard to evaluate LA function. The exact relationship between LA size and phasic...

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Main Authors: Chuyun Chen, Ying Yang, Wei Ma, Litong Qi, Baowei Zhang, Yan Zhang
Format: Article
Language:English
Published: BMC 2022-05-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12872-022-02672-z
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author Chuyun Chen
Ying Yang
Wei Ma
Litong Qi
Baowei Zhang
Yan Zhang
author_facet Chuyun Chen
Ying Yang
Wei Ma
Litong Qi
Baowei Zhang
Yan Zhang
author_sort Chuyun Chen
collection DOAJ
description Abstract Background Left atrial (LA) size is often used as a surrogate marker of LA function in clinical practice, with larger atrial thought to represent a “dysfunctioning” atrium, since there is no accepted ‘gold’ standard to evaluate LA function. The exact relationship between LA size and phasic function, and whether LA dysfunction occur before LA enlargement (LAE) may be of clinical interest while have not been fully studied. Two-dimensional speckle-tracking echocardiography (2D STE) was showed a promising method in measuring LA physical deformation. Materials and methods A community cohort of 715 subjects at cardiovascular disease high risk accepted comprehensive echocardiography. LA longitudinal phasic strain Sa (absolute peak strain during atrial contraction), Se (peak strain at early diastole) and Stot (total atrial strain = Sa + Se), representing contractile, conduit, and reservoir function respectively, were measured using off-line 2D STE software in apical 4 chamber view, and data were compared among groups at different LA size and between subgroups in normal LA size with and without hypertension (HT). Results With LAE (from normal size, mild, moderate to severe LAE), the Stot (21.74 ± 5.97, 20.75 ± 4.99, 20.49 ± 5.27, 17.75 ± 4.71, respectively, ANOVA P = 0.003) and Sa (11.84 ± 3.92, 11.00 ± 3.29, 10.11 ± 2.57, 8.55 ± 2.88, respectively, ANOVA P < 0.001) reduced while Se had no change. Stot of Severe LAE group was significantly lower than that of Normal LA size group (P = 0.002). Sa of the three LAE groups were all significantly lower than that of Normal LA size group (P = 0.024, P = 0.002, P < 0.001, respectively). In normal sized LA subgroups, Stot (21.35 ± 5.91 vs. 23.01 ± 6.02, P = 0.008) and Se (9.51 ± 4.41 vs. 11.17 ± 4.89, P < 0.001) reduced in subjects with HT comparing with those without. Conclusion LA phasic function remodeling occurs before LAE and continues with LAE, with reservoir, conduit and contractile function being affected unparalleled.
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spelling doaj.art-9eb92040b7094bbe82cd8d6577ff6f292022-12-22T02:34:24ZengBMCBMC Cardiovascular Disorders1471-22612022-05-012211910.1186/s12872-022-02672-zLeft atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography studyChuyun Chen0Ying Yang1Wei Ma2Litong Qi3Baowei Zhang4Yan Zhang5Department of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalDepartment of Cardiology, Peking University First HospitalAbstract Background Left atrial (LA) size is often used as a surrogate marker of LA function in clinical practice, with larger atrial thought to represent a “dysfunctioning” atrium, since there is no accepted ‘gold’ standard to evaluate LA function. The exact relationship between LA size and phasic function, and whether LA dysfunction occur before LA enlargement (LAE) may be of clinical interest while have not been fully studied. Two-dimensional speckle-tracking echocardiography (2D STE) was showed a promising method in measuring LA physical deformation. Materials and methods A community cohort of 715 subjects at cardiovascular disease high risk accepted comprehensive echocardiography. LA longitudinal phasic strain Sa (absolute peak strain during atrial contraction), Se (peak strain at early diastole) and Stot (total atrial strain = Sa + Se), representing contractile, conduit, and reservoir function respectively, were measured using off-line 2D STE software in apical 4 chamber view, and data were compared among groups at different LA size and between subgroups in normal LA size with and without hypertension (HT). Results With LAE (from normal size, mild, moderate to severe LAE), the Stot (21.74 ± 5.97, 20.75 ± 4.99, 20.49 ± 5.27, 17.75 ± 4.71, respectively, ANOVA P = 0.003) and Sa (11.84 ± 3.92, 11.00 ± 3.29, 10.11 ± 2.57, 8.55 ± 2.88, respectively, ANOVA P < 0.001) reduced while Se had no change. Stot of Severe LAE group was significantly lower than that of Normal LA size group (P = 0.002). Sa of the three LAE groups were all significantly lower than that of Normal LA size group (P = 0.024, P = 0.002, P < 0.001, respectively). In normal sized LA subgroups, Stot (21.35 ± 5.91 vs. 23.01 ± 6.02, P = 0.008) and Se (9.51 ± 4.41 vs. 11.17 ± 4.89, P < 0.001) reduced in subjects with HT comparing with those without. Conclusion LA phasic function remodeling occurs before LAE and continues with LAE, with reservoir, conduit and contractile function being affected unparalleled.https://doi.org/10.1186/s12872-022-02672-zAtrial functionSpeckle trackingHypertensionPhasic functionLeft atrial remodeling
spellingShingle Chuyun Chen
Ying Yang
Wei Ma
Litong Qi
Baowei Zhang
Yan Zhang
Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
BMC Cardiovascular Disorders
Atrial function
Speckle tracking
Hypertension
Phasic function
Left atrial remodeling
title Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
title_full Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
title_fullStr Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
title_full_unstemmed Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
title_short Left atrial phasic function remodeling during its enlargement: a two-dimensional speckle-tracking echocardiography study
title_sort left atrial phasic function remodeling during its enlargement a two dimensional speckle tracking echocardiography study
topic Atrial function
Speckle tracking
Hypertension
Phasic function
Left atrial remodeling
url https://doi.org/10.1186/s12872-022-02672-z
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