Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies
Abstract
:1. Background
2. Methods
2.1. Study Population
2.2. Standard Echocardiography
2.3. Two-Dimensional Speckle-Tracking Analysis
2.4. Cardiac Catheterization
2.5. Reproducibility Study
2.6. Statistical Analysis
3. Results
3.1. Traditional Diastolic Parameters
3.2. Longitudinal Strain Analyses
3.3. Atrial Strain Parameters
3.4. Left Atrial Strain Correlation with Invasive End-Diastolic Pressures
3.5. Reproducibility Analyses
4. Discussion
4.1. Left Atrial Strain and Standard Echo Doppler
4.2. Left Atrial Strain and Progressive Diastolic Dysfunction
4.3. Study Limitations
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Groups | ||||
---|---|---|---|---|
General and Echocardiographic Variables | CTRL (N = 45) | HCM (N = 40) | DCM (N = 44) | RCM (N = 7) |
Age (years) | 10.4 (4.7) | 10.9 (5.5) | 5.0 (5.2) | 10.0 (7.0) |
Male, n (%) | 18 (40) | 24 (61) | 21 (48) | 3 (43) |
Body Surface Area (BSA) (m2) | 1.2 (0.5) | 1.3 (0.5) | 0.8 (0.5) | 1.1 (0.6) |
Mean Heart Rate (bpm) | 85 (15) | 71 (22) | 115 (18) | 95 (18) |
LVEDD (mm) | 39.6 (7) | 34.5 (8) * | 44.5 (10) # | 35.3 (9) |
LVEDD Z score | −0.5 (0.8) | −1.7 (0.5) * | 3.5 (0.2) *,# | −1.1 (0.4) § |
IVS (mm) | 6.1 (1) | 13.5 (5) * | 5.1 (2) *,# | 7.1 (2) # |
IVS Z score | −0.4 (0.7) | 3.1 (0.2) * | -0.9 (0.9) # | 1.2 (0.7) § |
LVEF (%) | 60 (4) | 68 (7) * | 39 (12) *,# | 59 (8) #,§ |
Groups | ||||
---|---|---|---|---|
Diastolic Parameters | CTRL (N = 45) | HCM (N = 40) | DCM (N = 44) | RCM (N = 7) |
MV E vel (cm/sec) | 90.2 (13.8) | 95.6 (19.9) | 98.4 (25.8) | 80.0 (33.0) |
MV A vel (cm/sec) | 53.2 (14.7) | 59.2 (20.3) | 58.0 (20.1) | 34.8 (20.3) |
MV E/A (ratio) | 1.8 (0.5) | 1.8 (0.9) | 1.8 (0.8) | 2.5 (1.5) |
MV DT (msec) | 162 (45.8) | 219 (175.7) | 125 (123) # | 87 (40) * |
MV E’ sep (cm/sec) | 13.6 (2.0) | 8.3 (3.0) * | 9.3 (2.8) * | 6.2 (1.8) *,§ |
MV E’ lat (cm/sec) | 16.8 (3.4) | 11.2 (4.1) * | 11.3 (4.1) * | 8.0 (4.1) * |
MV E/E’ avg | 6.2 (1.2) | 11.5 (5.5) * | 10.7 (4.2) * | 12.4 (3.4) * |
LAVi (mL/m2) | 17.7 (4.9) | 24.6 (9.0) * | 29.6 (16.8) * | 59.6 (40.3) *,#,§ |
PTRG (mmHg) | 16.1 (2.0) | 21.9 (6.1) * | 24.3 (12.8) * | 43.8 (21.5) *,#,§ |
PV S/D | 1.0 (0.3) | 1.3 (0.3) | 1.0 (0.3) | 1.4 (0.7) |
Atrial and ventricular strain parameters | ||||
LV LS (%) | −21.5 (2.1) | −16.7 (3.0) * | −13.3 (5.3) *,# | −16.6 (2.3) * |
LA peak systolic strain (%) | 53.1 (12.0) | 30.1 (8.0) * | 22.8 (9.5) *,# | 9.8 (4.8) *,#,§ |
LA peak systolic strain rate (1/s) | 1.7 (0.3) | 1.1 (0.3) * | 0.9 (0.4) *,# | 0.4 (0.2) *,#,§ |
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Sabatino, J.; Di Salvo, G.; Prota, C.; Bucciarelli, V.; Josen, M.; Paredes, J.; Borrelli, N.; Sirico, D.; Prasad, S.; Indolfi, C.; et al. Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies. J. Clin. Med. 2019, 8, 1243. https://doi.org/10.3390/jcm8081243
Sabatino J, Di Salvo G, Prota C, Bucciarelli V, Josen M, Paredes J, Borrelli N, Sirico D, Prasad S, Indolfi C, et al. Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies. Journal of Clinical Medicine. 2019; 8(8):1243. https://doi.org/10.3390/jcm8081243
Chicago/Turabian StyleSabatino, Jolanda, Giovanni Di Salvo, Costantina Prota, Valentina Bucciarelli, Manjit Josen, Josefa Paredes, Nunzia Borrelli, Domenico Sirico, Sanjay Prasad, Ciro Indolfi, and et al. 2019. "Left Atrial Strain to Identify Diastolic Dysfunction in Children with Cardiomyopathies" Journal of Clinical Medicine 8, no. 8: 1243. https://doi.org/10.3390/jcm8081243