LA Strain for Categorization of LV Diastolic Dysfunction.
LA Strain for Categorization of LV Diastolic Dysfunction.
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DOI：
10.1016/j.jcmg.2016.08.014
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发表时间：
2017-07
期刊：
影响因子：
--
通讯作者：
Lang RM
中科院分区：
文献类型：
--
作者：
Singh A;Addetia K;Maffessanti F;Mor-Avi V;Lang RM
本研究旨在观察左心房（LA）应变与左室舒张功能的关系，并确定LA应变是否可用于检测舒张功能不全（DD）并对其程度进行分类。舒张功能的评估是复杂和多参数的，因为大多数常规参数不能跟随DD的进展。应变成像是LA功能的一个新兴指标，最近的数据表明，舒张期心力衰竭时LA应变降低。然而，LA应变不是舒张功能标准评估的一部分。我们假设LA应变随着DD的恶化而逐步减少，因此可以用于评估DD。我们进行了一项回顾性推导和验证队列研究，以在保留左心室射血分数（N = 229）的患者中推导和测试DD等级（0至3）的LA应变阈值。采用二维散斑跟踪测量LA峰值应变，将LA峰值应变作为单一参数对DD进行分类。以美国超声心动图学会指南作为参考标准。衍生队列（n = 90）中，LA菌株的峰值在DD组之间存在显著差异，随着DD的恶化，LA菌株的峰值逐渐降低。受体操作特征分析得出了3种不同的LA菌株阈值，用于DD分级分类，具有良好到优异的诊断效用（曲线下面积：0.86至0.91）。在具有舒张功能谱的独立验证组（n = 139）中，使用标准标准，11例患者（8%）的DD分级不确定，而在所有患者中测量LA菌株，其截止值导致诊断准确性高达95%。LA应变测量是可行的，可以准确地对DD进行分类，因为与传统参数不同，它随着DD的严重程度而逐渐变化。LA应变可能成为未来临床实践中舒张期评估的有用工具。
This study sought to observe the relationship between left atrial (LA) strain and left ventricular diastolic function and determine whether LA strain could be used to detect diastolic dysfunction (DD) and classify its degree when present. The assessment of diastolic function is complex and multiparametric because most conventional parameters do not follow the progression of DD. Strain imaging is an emerging index of LA function, with recent data demonstrating that LA strain is diminished in diastolic heart failure. However, LA strain is not part of the standard assessment of diastolic function. We hypothesized that LA strain decreases with worsening DD in a stepwise fashion and could thus be useful in evaluating DD. We performed a retrospective derivation and validation cohort study to derive and test LA strain thresholds for DD grades (0 to 3) in patients with preserved left ventricular ejection fraction (N = 229). Two-dimensional speckle tracking was used to measure peak LA strain, which was applied as a single parameter to classify DD. American Society of Echocardiography guidelines were used as the reference standard. In the derivation cohort (n = 90), peak LA strain was significantly different between DD groups, with gradual decreases seen with worsening DD. Receiver-operating characteristic analysis resulted in 3 distinct LA strain thresholds for categorization of DD grades, with good to excellent diagnostic utility (area under the curve: 0.86 to 0.91). In an independent validation group (n = 139) with a spectrum of diastolic function, 11 patients (8%) had indeterminate DD grades using standard criteria, whereas LA strain was measured in all patients and its cutoffs resulted in diagnostic accuracy up to 95%. LA strain measurements are feasible and allow accurate categorization of DD, because unlike the traditional parameters, it changes progressively with severity of DD. LA strain may become a useful tool for diastolic assessment in future clinical practice.
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影响因子：
1.9
作者：
Cameli, Matteo;Lisi, Matteo;Maccherini, Massimo
通讯作者：
Maccherini, Massimo
DOI：
10.1016/j.jash.2013.08.005
发表时间：
2014-01-01
影响因子：
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作者：
Miyoshi, Hirokazu;Oishi, Yoshifumi;Oki, Takashi
通讯作者：
Oki, Takashi
DOI：
10.1016/j.echo.2009.11.015
发表时间：
2010-02-01
影响因子：
6.5
作者：
Dokainish, Hisham;Nguyen, John S.;Lakkis, Nasser
通讯作者：
Lakkis, Nasser
影响因子：
6.2
作者：
Morris, Daniel A.;Takeuchi, Masaaki;Boldt, Leif-Hendrik
通讯作者：
Boldt, Leif-Hendrik
DOI：
10.1016/j.echo.2004.12.005
发表时间：
2005-07-01
影响因子：
6.5
作者：
Inaba, Y;Yuda, S;Shimamoto, K
通讯作者：
Shimamoto, K