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Association of asymptomatic diastolic dysfunction assessed by left atrial strain with incident heart failure

Potter, EL, Ramkumar, S, Kawakami, H, Yang, H, Wright, L, Negishi, T and Marwick, TH ORCID: 0000-0001-9065-0899 2020 , 'Association of asymptomatic diastolic dysfunction assessed by left atrial strain with incident heart failure' , JACC: Cardiovascular Imaging, vol. 13, no. 11 , pp. 2316-2326 , doi: 10.1016/j.jcmg.2020.04.028.

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Abstract

Objectives: This study is to establish the association of left atrial reservoir strain (LARS) with incident heart failure (HF), and the impact of substituting LARS for left atrial (LA) volume index (LAVI) in diastolic assessment.Background: LARS measures passive LA stretch and is a sensitive marker of left ventricular diastolic dysfunction (DD). The potential contribution of LARS to diastolic assessment is unclear.Methods: Baseline clinical and echocardiographic assessments were obtained in 758 asymptomatic, community-dwelling elderly subjects (age 70 [interquartile range: 67 to 74] years, 53% women) with nonischemic HF risk factors. LARS-defined DD (LARS-DD) was assessed by speckle-tracking echocardiography, and grades were assigned as normal (>35%), grade 1 (25% to 35%) and grade 2 (≤24%). DD grade using current recommendations was compared with grading using LARS 34 ml/m2. Patients were followed for up to 2 years for incident HF. Results: LA strain analysis was feasible in 738 (97%) patients; average LARS was 39% (range 34% to 43%). Incident HF was associated with LARS-DD grade; 8 (36%) of those had grade 2+, 14 (10%) had grade 1, and 39 (9%) had normal function (p Conclusions: LARS-DD grade 2+ is associated with incident HF in the elderly, independent of LAVI. The substitution of LARS for LAVI reduces the number of indeterminate cases without impacting prognosis in normal diastolic function and grade 1 DD.

Item Type: Article
Authors/Creators:Potter, EL and Ramkumar, S and Kawakami, H and Yang, H and Wright, L and Negishi, T and Marwick, TH
Keywords: diastolic dysfunction, heart failure, left atrial strain
Journal or Publication Title: JACC: Cardiovascular Imaging
Publisher: Elsevier Inc.
ISSN: 1936-878X
DOI / ID Number: 10.1016/j.jcmg.2020.04.028
Copyright Information:

Copyright 2020 American College of Cardiology Foundation

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