1. Left atrial strain analysis improves left ventricular filling pressures non-invasive estimation in the acute phase of Takotsubo syndrome.
- Author
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Iannaccone, Giulia, Graziani, Francesca, Buono, Marco Giuseppe Del, Camilli, Massimiliano, Lillo, Rosa, Caffè, Andrea, Moroni, Francesco, Vecchia, Giulia La, Pedicino, Daniela, Sanna, Tommaso, Trani, Carlo, Lombardo, Antonella, Lanza, Gaetano Antonio, Massetti, Massimo, Crea, Filippo, and Montone, Rocco A
- Subjects
LEFT heart ventricle ,ECHOCARDIOGRAPHY ,CARDIAC catheterization ,CAUSES of death ,TAKOTSUBO cardiomyopathy ,CONFIDENCE intervals ,VENTRICULAR ejection fraction ,MAJOR adverse cardiovascular events ,TRICUSPID valve diseases ,GLOBAL longitudinal strain ,MANN Whitney U Test ,FISHER exact test ,DIASTOLIC blood pressure ,RISK assessment ,DIAGNOSTIC imaging ,CORONARY angiography ,HOSPITAL mortality ,VENTRICULAR tachycardia ,HOSPITAL care ,DESCRIPTIVE statistics ,CHI-squared test ,RECEIVER operating characteristic curves ,DATA analysis software ,LOGISTIC regression analysis ,STATISTICAL models ,ARRHYTHMIA ,LEFT heart atrium ,LONGITUDINAL method ,HEART failure ,DISEASE risk factors - Abstract
Aims The aim of our study is to assess the ability of left atrial (LA) strain values to improve left ventricular and diastolic pressure (LVEDP) non-invasive estimation as compared with traditional echocardiographic indexes in the acute phase of Takotsubo syndrome (TTS) and to predict adverse in-hospital outcomes in this population. Methods and results Consecutive TTS patients were prospectively enrolled. Left ventricular and diastolic pressure was measured at the time of catheterization. Transthoracic echocardiography was performed within 48 h from hospital admission. In-hospital complications (acute heart failure, death from any cause, and life-threatening arrhythmias) were collected. A total of 62 patients were analysed (72.2 ± 10.1 years, female 80%) and in-hospital complications occurred in 25 (40.3%). Left ventricular and diastolic pressure mean value was 24.53 ± 7.92 mmHg. Left atrial reservoir and pump strain values presented higher correlation with LVEDP (r −0.859, P < 0.001 and r −0.848, P < 0.001, respectively) in comparison with E / e ′ ratio, left atrial volume index (LAVi), and tricuspid regurgitation (TR) peak velocity. In addition, at receiver-operating characteristic curve analysis, LA reservoir and pump strain resulted to be better predictors of LVEDP above the mean of our population [0.909 (95% CI 0.818–0.999, P < 0.001) and 0.889 (95% CI 0.789–0.988, P < 0.001)], respectively] as compared with E / e ′ ratio, LAVi, and TR peak velocity. Finally, LA reservoir strain resulted to be an independent predictor of worse in-hospital outcomes, together with LVEDP and left ventricular ejection fraction (all P < 0.001). Conclusion In our study, lower LA reservoir and pump strain values were better predictors of LVEDP as compared with traditional echocardiographic indexes in the acute phase of TTS syndrome. Moreover, LA reservoir strain was an independent predictor of adverse in-hospital outcomes. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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