Ghulam Murtaza1, Venkat Vuddanda2, Krishna Akella1, Domenico G Della Rocca3, Sharan Sharma1, Ling Li4, Shelby Kutty4, Mohit Turagam5, Saibal Kar6, David Holmes7, Dhanunjaya Lakkireddy8. 1. The Kansas City Heart Rhythm Institute & Research Foundation, 5100 W 110th St Second Floor, Overland Park, KS, 66211, USA. 2. Harvard Medical School, 25 Shattuck St, Boston, MA, 02115, USA. 3. Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N Interstate Hwy 35, Austin, TX, 78705, USA. 4. Division of Pediatric Cardiology, Johns Hopkins Medical Center, 600 N Wolfe St, Baltimore, MD, 21205, USA. 5. Mt. Sinai Hospital, 1468 Madison Ave, New York, NY, 10029, USA. 6. , Los Angeles, USA. 7. Mayo Clinic, Rochester, MN, USA. 8. The Kansas City Heart Rhythm Institute & Research Foundation, 5100 W 110th St Second Floor, Overland Park, KS, 66211, USA. dlakkireddy@gmail.com.
Abstract
BACKGROUND: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. OBJECTIVE: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). METHODS: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. RESULTS: Mean age was 76 ± 6.9 years with 60% males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9-35.9) vs pre 21.0 (13.8-34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3-98.0) vs pre 58.1 (37.8-85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7-29.9) vs pre 12.6 (8.8-25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post - 0.56 (0.43-0.93) vs pre - 0.58 (0.46-0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28-0.40) vs pre + 0.52 (0.35-0.86); p = 0.851). CONCLUSIONS: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.
BACKGROUND: Left atrial (LA) strain and strain rate (SR) analysis by two-dimensional speckle tracking echocardiography is a novel way of LA function assessment. From prior study, we know that LA appendage closure with LARIAT appears to improve LA function. OBJECTIVE: The purpose of this study was to assess the impact of LAA closure via Watchman device on LA function via strain and volumetric analyses using two-dimensional speckle tracking echocardiography (2D-STE). METHODS: Twenty-five patients who underwent Watchman device implantation (WDI) were included. LA function parameters (volumetric, strain indices) were calculated from apical four chamber views with the reference point set at QRS using 2D-STE before and after WDI. LA expansion index, strain and strain rate during ventricular systole represent LA reservoir function. Passive emptying fraction, strain and strain rate during early ventricular diastole represent LA conduit function. RESULTS: Mean age was 76 ± 6.9 years with 60% males. There was significant improvement in conduit function (LA passive emptying fraction; post 28.6 (21.9-35.9) vs pre 21.0 (13.8-34.7), p = 0.032), reservoir function (LA expansion index; post 75.3 (52.3-98.0) vs pre 58.1 (37.8-85.2), p = 0.026), and booster function (LA active emptying fraction; post 13.3 (9.7-29.9) vs pre 12.6 (8.8-25.5), p = 0.04) by volumetric indices. No significant improvement was noted with strain indices in conduit function (SRe; post - 0.56 (0.43-0.93) vs pre - 0.58 (0.46-0.87); p = 0.518) and reservoir function (SRs; post + 0.58 (0.28-0.40) vs pre + 0.52 (0.35-0.86); p = 0.851). CONCLUSIONS: WDI resulted in discrepancy of volumetric and strain indices in LA function assessment.
Authors: Fabrizio Rosati; Gijs E de Maat; Mattia A E Valente; Massimo A Mariani; Stefano Benussi Journal: J Cardiovasc Electrophysiol Date: 2021-08-04 Impact factor: 2.942