Clinical and Interventional Cardiology, Sassari University Hospital, Via Enrico De Nicola, 07100, Sassari, Italy.
The Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.
Int J Cardiovasc Imaging. 2022 Aug;38(8):1723-1732. doi: 10.1007/s10554-022-02562-7. Epub 2022 Feb 25.
Left atrial sphericity index (LASI) is an echocardiographic index easily obtained; its use in patients with heart failure (HF) has never been investigated so far. This single-centre study aimed to investigate the usefulness of LASI in an unselected cohort of patients hospitalized for acute HF, and its potential correlation with the amino-terminal portion of pro-B-type natriuretic peptide (NT-proBNP) levels and with New York Heart Association (NYHA) functional class. Ninety-four consecutive HF patients underwent a transthoracic echocardiogram with a detailed study of the left atrium (LA) including LASI (calculated from the apical four-chamber view as the ratio between the transverse and longitudinal diameters), and blood tests (including NT-proBNP) on the same day. Median age was 75.5 (interquartile range-IQR 62-82) years and 55% were males, 58.5% had a NYHA class III-IV, and median NT-proBNP was 3284 (IQR 1215-7055) pg/ml. The LA was dilated in 94%, and median biplane LA volume index was 62 ml/m. Patients with advanced NYHA class showed more advanced LA remodeling. Mean LASI was 0.78 ± 0.09 and did not correlate with NT-proBNP levels (r 0.03; p 0.75) or with patient NYHA class (R 0.011; p 0.287). None of the echocardiographic indices of LA structural and functional remodeling proved to be independently associated with a high NYHA class on multivariate regression analysis. In conclusion, LA remodeling is almost invariably present in patients with HF. LASI does not correlate with NT-proBNP levels or with NYHA functional class. Further studies are needed to describe the complex patterns of atrial remodeling in HF.
左心房球形指数（LASI）是一种易于获得的超声心动图指数；迄今为止，尚未有研究调查其在心力衰竭（HF）患者中的应用。这项单中心研究旨在调查 LASI 在因急性 HF 住院的未经选择的患者队列中的有用性，及其与氨基末端脑利钠肽前体（NT-proBNP）水平和纽约心脏协会（NYHA）功能分级的潜在相关性。94 例连续 HF 患者接受了经胸超声心动图检查，对左心房（LA）进行了详细研究，包括 LASI（从心尖四腔视图计算，作为横向和纵向直径的比值），并在同一天进行了血液检查（包括 NT-proBNP）。中位年龄为 75.5 岁（四分位距 IQR 62-82），55%为男性，58.5%为 NYHA 分级 III-IV，中位 NT-proBNP 为 3284（IQR 1215-7055）pg/ml。94%的 LA 扩张，双平面 LA 容积指数中位数为 62 ml/m。NYHA 分级较高的患者表现出更严重的 LA 重构。平均 LASI 为 0.78±0.09，与 NT-proBNP 水平无关（r 0.03；p 0.75）或与患者 NYHA 分级无关（R 0.011；p 0.287）。在多变量回归分析中，LA 结构和功能重构的超声心动图指数均与高 NYHA 分级无关。总之，HF 患者的 LA 重构几乎总是存在。LASI 与 NT-proBNP 水平或 NYHA 功能分级无关。需要进一步研究来描述 HF 中心房重构的复杂模式。
