Original Article

Correlation of Left Atrial Echocardiographic Deformation Parameters and Invasively Measured Left Ventricular End‐Diastolic Pressure

Abstract

Background: Noninvasive estimation of elevated left ventricular end-diastolic pressure (LVEDP) is a necessary step in evaluating left ventricular diastolic dysfunction (LVDD). Most echocardiographic parameters used for this purpose have limitations. Left atrial (LA) strain was recently found useful for noninvasive estimation of LVEDP. Therefore, this study aimed to investigate the correlations between LA deformation parameters assessed by speckle-tracking echocardiography (STE) and invasively obtained LVEDP.

Methods: This study was prospectively performed on 82 patients in sinus rhythm who underwent left heart catheterization at our center. All the patients underwent complete transthoracic echocardiography and peak atrial longitudinal strain (PALS) evaluation by STE within 12 hours before catheterization.

Results: LVEDP was elevated in 45 patients (54.9%) and normal in 37 (45.1%). PALS, LA ejection fraction, and septal E’ had moderate inverse correlations with LVEDP (r= −0.590, P=0.001, r= −0.463, P=0.001, and r= −0.449, P=0.001, respectively). The E/E` ratio also had a moderate correlation with LVEDP (r= 0.567, P=0.001). Lateral E’ and the E/A ratio demonstrated a rather weak inverse correlation with LVEDP (r= −0.231, P=0.037 and r= −0.229, P=0.038, respectively). In multivariate logistic regression, age (OR, 1.14; 95% CI, 1.02 to 1.27), PALS (OR, 0.77; 95% CI, 0.65 to 0.91), and the E/E` ratio (OR, 1.36; 95% CI, 1.11 to 1.89) were independent predictors of an LVEDP≥12 mm Hg. PALS demonstrated the highest diagnostic accuracy 0.849 (0.764–0.935, P<0.001) to predict an LVEDP≥12 mm Hg. A cutoff of 35% had sensitivity =81.1%, and specificity =81.4% for prediction of increased LVEDP.

Conclusions: PALS proved to be a suitable noninvasive parameter to predict elevated LVEDP. It can potentially be used as a measure for earlier identification of LVDD.

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Keywords
Left atrium longitudinal strain Left ventricular end‐diastolic pressure Echocardiography Cardiac catheterization Speckle tracking Diastolic dysfunction
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1.
Farrashi M, Noroozi M, Khesali H, Baay M, Khalilipur E, Cheraghi saeed, Salmannejad R, Salehi E, Bakhshandeh H, Emami E. Correlation of Left Atrial Echocardiographic Deformation Parameters and Invasively Measured Left Ventricular End‐Diastolic Pressure. J Tehran Heart Cent. 2024;.