The Physiological Laboratory, Osaka Minato Central Hospital, Isoji, 1-7-1, Minato-ku, Osaka, 552-0003, Japan.
The Cardiology Department of the Internal Medicine and Physiological Laboratory, Osaka Minato Central Hospital, Osaka, Japan.
J Echocardiogr. 2023 Dec;21(4):149-156. doi: 10.1007/s12574-023-00605-z. Epub 2023 Jun 1.
The effects of left ventricular longitudinal function on the left atrial strain, including the left atrial reservoir function, have not been adequately quantified.
A total of 124 patients who underwent echocardiography were enrolled in this study. Left atrial strain analysis was performed using two-dimensional speckle tracking echocardiography, and the left atrial volume was derived using the modified Simpson's method. The peak left atrial strain (LAS) and left atrial expansion index (LAEI), as indices of left atrial reservoir function, were measured. The global longitudinal strain (GLS) and mitral annular plane systolic excursion (MAPSE), which are indices of contractile motion toward the left ventricular apex, were also measured. The correlation between LAS and candidate determinants, including left ventricular systolic longitudinal function, was evaluated, and multivariate regression analysis was performed.
A significant correlation was found between LAS and left ventricular systolic longitudinal functions, GLS (r = 0.63, p < 0.001), and MAPSE (r = 0.65, p < 0.001). Two models, which were selected by multiple regression analyses for LAS, included GLS or MAPSE as independent determinants. GLS and MAPSE were also the strongest predictors, among other factors.
LAS, when determined by evaluating the left atrial reservoir function, was significantly associated with left ventricular function, especially the systolic longitudinal function. Left ventricular function should be considered when assessing left atrial function by LAS.
左心室纵向功能对左心房应变的影响,包括左心房储备功能,尚未得到充分量化。
本研究共纳入 124 例行超声心动图检查的患者。使用二维斑点追踪超声心动图进行左心房应变分析,并使用改良 Simpson 法得出左心房容积。测量左心房峰值应变(LAS)和左心房扩张指数(LAEI),作为左心房储备功能的指标。还测量了整体纵向应变(GLS)和二尖瓣环平面收缩期位移(MAPSE),作为向左心室心尖收缩运动的指标。评估了 LAS 与候选决定因素(包括左心室收缩纵向功能)之间的相关性,并进行了多元回归分析。
LAS 与左心室收缩纵向功能、GLS(r=0.63,p<0.001)和 MAPSE(r=0.65,p<0.001)呈显著相关。多因素回归分析选择了两个模型用于 LAS,包括 GLS 或 MAPSE 作为独立决定因素。GLS 和 MAPSE 也是其他因素中最强的预测指标。
通过评估左心房储备功能确定的 LAS 与左心室功能显著相关,尤其是收缩纵向功能。在通过 LAS 评估左心房功能时,应考虑左心室功能。