Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, No. 155 Nanjingbei Street, Shenyang, 110001, Liaoning, People's Republic of China.
BMC Cardiovasc Disord. 2021 Feb 23;21(1):110. doi: 10.1186/s12872-021-01920-y.
Left atrial (LA) volume (LAV) is one of the recommended key variables for evaluating left ventricular (LV) diastolic function. However, only LA anteroposterior diameter (LAAP) is available in numerous large-scale existing databases. Therefore, this study aimed to validate whether LV diastolic function could be evaluated with estimated LAV from LAAP.
A total of 552 inpatients with sinus rhythm were consecutively enrolled. LAV was measured by biplane Simpson's disk summation method. LV diastolic function was evaluated according to the 2016 proposed recommendations. Best-fitting regression models of LAAP index (LAAPI)-LAV index (LAVI) were developed and equations with the highest F-value were chosen in the first 276 subjects (derivation set), and concordance for evaluating LV diastolic function between using estimated and observed LAVI was verified in the remaining 276 subjects (validation set).
In the derivation set, the linear model has the highest F-value in all subjects and in the subjects with normal or depressed LV ejection fraction. In the validation set, using the linear equation (LAVI = 2.05 × LAAPI - 13.86), the higher area under curve and narrower range of difference were shown between estimated LAVI and observed LAVI, respectively. Further, concordance for diagnosis (overall proportion of agreement, 88.4%; κ = 0.79) and grading (overall proportion of agreement, 84.8%; κ = 0.74) of LV diastolic dysfunction was substantial between using estimated and observed LAVI.
LV diastolic function can be evaluated with estimated LAVI from LAAPI, which might provide a surrogate method when the direct measurement of LAV is not available.
左心房（LA）容积（LAV）是评估左心室（LV）舒张功能的推荐关键变量之一。然而，在许多大型现有数据库中仅提供 LA 前后直径（LAAP）。因此，本研究旨在验证是否可以使用 LAAP 估算的 LAV 评估 LV 舒张功能。
连续纳入 552 例窦性心律住院患者。使用双平面 Simpson 盘求和法测量 LAV。根据 2016 年提出的建议评估 LV 舒张功能。在最初的 276 例患者（推导组）中建立 LAAP 指数（LAAPI）-LAV 指数（LAVI）的最佳拟合回归模型，并选择 F 值最高的方程，在其余 276 例患者（验证组）中验证使用估算和观察 LAVI 评估 LV 舒张功能的一致性。
在推导组中，所有患者和 LV 射血分数正常或降低的患者中，线性模型的 F 值最高。在验证组中，使用线性方程（LAVI=2.05×LAAPI-13.86），估算的 LAVI 与观察的 LAVI 之间的曲线下面积更高，差异范围更窄。此外，在使用估算和观察 LAVI 进行诊断（总体一致性比例，88.4%；κ=0.79）和分级（总体一致性比例，84.8%；κ=0.74）方面，一致性较高。
可以使用 LAAPI 估算的 LAVI 评估 LV 舒张功能，当无法直接测量 LAV 时，这可能提供一种替代方法。
