Buggey Jonathan, Hoit Brian D
University Hospitals Cleveland Medical Center, Harrington Heart and Vascular Institute.
Case Western Reserve University, Cleveland, Ohio, USA.
Curr Opin Cardiol. 2018 Sep;33(5):479-485. doi: 10.1097/HCO.0000000000000537.
To summarize recent literature on the use of left atrial strain in the diagnosis and management of patients with heart failure.
Left atrial dysfunction is a hallmark of diastolic dysfunction and heart failure, in particular, heart failure with preserved ejection fraction (HFpEF). Recently, myocardial deformation analysis via strain and strain rate measurements have been applied to the left atrium. These measurements have been shown to aid in the diagnosis of heart failure and be accurate predictors of cardiac pressures, diastolic dysfunction, exercise performance, and clinical outcomes such as cardiac hospitalizations and mortality. However, limitations related to the technical aspect of accurately imaging and tracking the thin-walled left atrium and the current lack of consensus on 'normal' reference values remain.
Left atrial strain represents a novel, noninvasive technique to aid in the diagnosis, prognosis, and management of patients with heart failure. Although it is not yet a part of routine clinical practice, the measurement has significant promise within this population pending further validation.
总结近期关于左心房应变在心力衰竭患者诊断和管理中应用的文献。
左心房功能障碍是舒张功能障碍和心力衰竭的标志，尤其是射血分数保留的心力衰竭（HFpEF）。最近，通过应变和应变率测量进行的心肌变形分析已应用于左心房。这些测量已被证明有助于心力衰竭的诊断，并且是心脏压力、舒张功能障碍、运动能力以及诸如心脏住院和死亡率等临床结局的准确预测指标。然而，与准确成像和跟踪薄壁左心房的技术方面相关的局限性以及目前对“正常”参考值缺乏共识仍然存在。
左心房应变是一种有助于心力衰竭患者诊断、预后和管理的新型非侵入性技术。虽然它尚未成为常规临床实践的一部分，但在进一步验证之前，该测量在这一人群中具有很大的前景。
