Jo-Nan Liao1, Tze-Fan Chao1, Jen-Yuan Kuo1, Kuo-Tzu Sung1, Jui-Peng Tsai1, Chi-In Lo1, Yau-Huei Lai1, Cheng-Huang Su1, Chung-Lieh Hung2, Hung-I Yeh1, Shih-Ann Chen2. 1. From the Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (J.-N.L., T.-F.C, S.-A.C.); Institute of Clinical Medicine (J.-N.L., T.-F.C, S.-A.C.) and Cardiovascular Research Center (J.-N.L., T.-F.C, S.-A.C.), National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.); Medical Research (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.) and Division of Cardiology, Department of Internal Medicine (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.), MacKay Memorial Hospital, Taipei, Taiwan; and MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). 2. From the Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan (J.-N.L., T.-F.C, S.-A.C.); Institute of Clinical Medicine (J.-N.L., T.-F.C, S.-A.C.) and Cardiovascular Research Center (J.-N.L., T.-F.C, S.-A.C.), National Yang-Ming University, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.); Medical Research (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.) and Division of Cardiology, Department of Internal Medicine (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.), MacKay Memorial Hospital, Taipei, Taiwan; and MacKay Junior College of Medicine, Nursing and Management, New Taipei City, Taiwan (J.-Y.K., K.-T.S., J.-P.T., C.-I.L., Y.-H.L., C.-H.S., C.-L.H., H.-I.Y.). jotaro3791@gmail.com epsachen@ms41.hinet.net.
Abstract
BACKGROUND: Left atrial (LA) function is tightly linked to several cardiovascular diseases and confers key prognostic information. Speckle tracking-based deformation as a feasible and sensitive LA mechanical assessment has proven its clinical significance beyond volume measures; however, the reference values remain largely unknown. METHODS AND RESULTS: We studied 4042 participants undergoing annual cardiovascular survey. Among them, 2812 healthy participants (65% men; mean age, 47.4±9.9 years) were eligible for speckle tracking analysis. Peak atrial longitudinal systolic strain and strain rate (SR) at systolic (SRs), early diastolic (SRe), and late diastolic atrial contraction phases (SRa) were analyzed by dedicated software (EchoPAC, GE) and compared in terms of age, sex, and blood pressure. Overall, women demonstrated higher peak atrial longitudinal systolic strain (39.34±7.99% versus 37.95±7.96%; P<0.001) and showed age-dependent more pronounced peak atrial longitudinal systolic strain functional decay than those of men (P value for interaction, <0.05), with men showing higher SRs and SRa, although lower SRe (all P<0.001). Both increasing age and higher blood pressure were independently associated with deteriorated peak atrial longitudinal systolic strain, SRs, and SRe, although augmented LA SRa, even after accounting for baseline clinical covariates in multivariable models that incorporated LA volume, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or left ventricular E/e' (all P<0.001). CONCLUSIONS: Our findings suggest LA mechanical functional decays in association with increasing age and higher blood pressure, which seem to be compensated for by augmentation of atrial pump function. We have also provided age- and sex-stratified reference values for strain and SR based on a large-scale Asian population.
BACKGROUND: Left atrial (LA) function is tightly linked to several cardiovascular diseases and confers key prognostic information. Speckle tracking-based deformation as a feasible and sensitive LA mechanical assessment has proven its clinical significance beyond volume measures; however, the reference values remain largely unknown. METHODS AND RESULTS: We studied 4042 participants undergoing annual cardiovascular survey. Among them, 2812 healthy participants (65% men; mean age, 47.4±9.9 years) were eligible for speckle tracking analysis. Peak atrial longitudinal systolic strain and strain rate (SR) at systolic (SRs), early diastolic (SRe), and late diastolic atrial contraction phases (SRa) were analyzed by dedicated software (EchoPAC, GE) and compared in terms of age, sex, and blood pressure. Overall, women demonstrated higher peak atrial longitudinal systolic strain (39.34±7.99% versus 37.95±7.96%; P<0.001) and showed age-dependent more pronounced peak atrial longitudinal systolic strain functional decay than those of men (P value for interaction, <0.05), with men showing higher SRs and SRa, although lower SRe (all P<0.001). Both increasing age and higher blood pressure were independently associated with deteriorated peak atrial longitudinal systolic strain, SRs, and SRe, although augmented LA SRa, even after accounting for baseline clinical covariates in multivariable models that incorporated LA volume, NT-proBNP (N-terminal pro-B-type natriuretic peptide), or left ventricular E/e' (all P<0.001). CONCLUSIONS: Our findings suggest LA mechanical functional decays in association with increasing age and higher blood pressure, which seem to be compensated for by augmentation of atrial pump function. We have also provided age- and sex-stratified reference values for strain and SR based on a large-scale Asian population.
Authors: Francesco Bandera; Anita Mollo; Matteo Frigelli; Giulia Guglielmi; Nicoletta Ventrella; Maria Concetta Pastore; Matteo Cameli; Marco Guazzi Journal: Front Cardiovasc Med Date: 2022-01-13
Authors: Paul Welsh; Ross T Campbell; Leanne Mooney; Dorien M Kimenai; Caroline Hayward; Archie Campbell; David Porteous; Nicholas L Mills; Ninian N Lang; Mark C Petrie; James L Januzzi; John J V McMurray; Naveed Sattar Journal: Circ Heart Fail Date: 2022-09-13 Impact factor: 10.447