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Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in end-stage renal disease patients with preserved left ventricular ejection fraction

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Abstract

Background

In end-stage renal disease patients with preserved LV ejection fraction undergoing chronic hemodialysis, we investigated the relationship of left atrial deformational parameters evaluated by two-dimensional speckle tracking imaging (2D-STI) with conventional echocardiographic diastolic dysfunction parameters and brain natriuretic peptide level.

Methods

The study group enrolled 30 patients treated with chronic hemodialysis three times weekly. Two-dimensional transthoracic echocardiography and Doppler studies were performed 44.93 (13.46) immediately before and after HD. All patients had preserved left ventricular ejection fraction.

Results

The mean age of patients was 44.93 ± 13.46 years. The mean brain natriuretic peptide (BNP) value after HD was 221.56 ± 197.79 pg/ml. BNP values were significantly higher before HD (p = 0.004), the anteroposterior diameter, area, and the volumes of the LA decreased significantly after HD. On the other hand, the left atrial ejection fraction (LAEF) and the peak LA strain during LV systole (LAGS) were found to be higher. Before HD, there were significant inverse correlations between LAGS and BNP levels (r = −0.482, p = 0.007), E/E′ (r = −0.33, p = 0.049), LAVmax (r = −0.366, p = 0.047), and LAVmin (r = –0.579, p = 0.001). LAGS had a significant correlation with E′ velocity (r = 0.557, p = 0.001) (Table 5) and LAEF (r = 0.58, p = 0.001). After HD, there were also significant correlations between LAGS and echocardiographic parameters of systolic and diastolic LV function.

Conclusions

We observed that left atrium global peak systolic strain values decreased consistently with deteriorating systolic and diastolic function. Our results suggest that LAGS measurements may be helpful as a complimentary method to evaluate diastolic function.

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Authors and Affiliations

  1. Cardiology Department, Hedi Chaker Hospital, Route Elain, Km 0.5, 3029, Sfax, Tunisia

    Leila Abid, Salma Charfeddine & Samir Kammoun

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  1. Leila Abid
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  2. Salma Charfeddine
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Correspondence to Leila Abid.

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Abid L, S Charfeddine, and S Kammoun declare that they have no conflicts of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later revisions. Informed consent was obtained from all patients for being included in the study.

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Abid, L., Charfeddine, S. & Kammoun, S. Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in end-stage renal disease patients with preserved left ventricular ejection fraction. J Echocardiogr 14, 71–78 (2016). https://doi.org/10.1007/s12574-016-0276-6

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  • DOI: https://doi.org/10.1007/s12574-016-0276-6

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