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Left atrial function analysis in patients in sinus rhythm, normal left ventricular function and indeterminate diastolic function

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Abstract

Assessment of diastolic function by echocardiography may be indeterminate as demonstrated in previous studies where diastolic measurement is a discrepant. We aimed to assess whether left atrial (LA) function may contribute to left ventricle filling evaluation in patients with indeterminate diastolic function (IndtDFx). This retrospective study included 3 groups of patients based on diastolic function: normal diastolic function (NDFx), definite diastolic dysfunction (DDFx) and IndtDFx. All patients had sinus rhythm with left ventricular ejection fraction ≥ 45%. Diastolic function was determined according to the following echocardiographic parameters: mitral Eʹ, mitral E/Eʹ ratio, LA maximal volume index, and pulmonary pressure. NDFx was defined as having less than 2 abnormal parameters, DDFx as more than 2 abnormal parameters, and IndtDFx as 2 abnormal parameters. LA function analysis was performed in all patients using echocardiographic 2D speckle tracking. Sixty seven patients were included in strain analysis. The DDFx group (n = 21) and IndtDFx (n = 19) were significantly different from NDFx (27) in some demographics, cardiovascular risk factors, presentation and echocardiographic parameters. Some of the phasic LA function (phasic LA volumes and strains) parameters in the IndtDFx group were similar to DDFx and significantly different from the NDFx group, while other parameters fell in between the two groups. Phasic LA minimal volume index was found to be associated with heart failure symptoms. The IndtDFx group is a heterogeneous group demonstrating clinical and echocardiographic profiles that closely resemble that of DDFx group. LA phasic function analysis may help in re-classification of patients with IndtDFx as actual DDFx or as NDFx.

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Author notes

  1. Ibrahim Marai and Matan Shimron have equal contributions in this study.

Authors and Affiliations

  1. The Lidya and Carol Kittner, Lea and Benjamin Davidai Cardiovascular Division, Poriya Medical Center, Lower Galilee, Israel

    Ibrahim Marai, Matan Shimron, Eevgeni Hazanov, Wadia Kinany, Liza Grosman-Rimon & Shemy Carasso

  2. The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, 8 Henrietta Szold street, Safed, Israel

    Ibrahim Marai, Matan Shimron, Eevgeni Hazanov, Wadia Kinany, Liza Grosman-Rimon, Offer Amir & Shemy Carasso

  3. Department of Cardiology, Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom

    Lynne Williams

  4. Cardiology Department, Hadassah Medical Center, Faculty of Medicine, Hebrew University, Jerusalem, Israel

    Offer Amir

Authors
  1. Ibrahim Marai
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  2. Matan Shimron
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  3. Lynne Williams
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  4. Eevgeni Hazanov
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  6. Liza Grosman-Rimon
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  7. Offer Amir
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  8. Shemy Carasso
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Correspondence to Shemy Carasso.

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Marai, I., Shimron, M., Williams, L. et al. Left atrial function analysis in patients in sinus rhythm, normal left ventricular function and indeterminate diastolic function. Int J Cardiovasc Imaging 38, 543–549 (2022). https://doi.org/10.1007/s10554-021-02425-7

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  • DOI: https://doi.org/10.1007/s10554-021-02425-7

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