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Left atrial mechanics in children: insights from new applications of strain imaging

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Abstract

Our principal aim was to describe functional changes in dilated left atrium (LA) of children by using new applications of LA strain. We studied 66 patients (age range 0.2–22 years) consisting of 33 with LA enlargement. We utilized speckle-tracking imaging for assessment LA longitudinal strain (S) and longitudinal displacement (D). S–D loops were generated by plotting S and D data along Y and X axes, respectively. We also measured noninvasive LA stiffness index, \(=\frac{{E/e^{\prime}}}{{LA~peak~strain}}~\) (%−1). Peak S in controls was 51.16 ± 19.45% versus 23.16 ± 13.66% in dilated LA (p < 0.0001). S–D loops in dilated LA group were significantly smaller compared to controls (2.62 ± 2.88 units vs. 5.24 ± 4.00 units, p < 0.01). Noninvasive LA stiffness index was higher in dilated LA group (0.77 ± 0.63%−1 vs. 0.17 ± 0.07%−1, p < 0.0001). A cut-off LA stiffness value of 0.25%−1 was found to maximize sensitivity and specificity (84.0% and 84.85%, respectively). Children with enlarged LA demonstrate decreased peak S, abnormal S–D loops and increased LA stiffness, providing a newer insight into LA function. Evaluation of LA mechanics may be applied in future as a surrogate for left ventricular filling parameters.

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Abbreviations

STE:

Speckle tracking echocardiography

LA:

Left atrium

LV:

Left ventricle

DICOM:

Digital imaging and communications in medicine

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Acknowledgements

We wish to thank Ms. Xuemei Zhang of the Children’s Hospital of Philadelphia, for providing statistical help for our study.

Funding

This research did not receive any grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Cardiology, The Children’s Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, 34th and Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Kyle D. Hope, Yan Wang, Maalika M. Banerjee, Andrea E. Montero & Anirban Banerjee

  2. Division of Cardiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, 02111, USA

    Maalika M. Banerjee & Natesa G. Pandian

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  1. Kyle D. Hope
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  2. Yan Wang
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  3. Maalika M. Banerjee
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  4. Andrea E. Montero
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  5. Natesa G. Pandian
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  6. Anirban Banerjee
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Correspondence to Anirban Banerjee.

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None of the authors have any conflict of interest that could have influence the manuscript.

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This study was approved by the Institutional Review Board of The Children’s Hospital of Philadelphia.

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Informed consent was not obtained as this was a retrospective study.

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Hope, K.D., Wang, Y., Banerjee, M.M. et al. Left atrial mechanics in children: insights from new applications of strain imaging. Int J Cardiovasc Imaging 35, 57–65 (2019). https://doi.org/10.1007/s10554-018-1429-7

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  • DOI: https://doi.org/10.1007/s10554-018-1429-7

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