Lisa Q Rong1, Ajay Menon2, Alexandra J Lopes3, Hannah Agoglia2, Katherine Tak2, Richard B Devereux2, Mohamed Rahouma4, Mario Gaudino4, Jonathan W Weinsaft2, Jiwon Kim2. 1. Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY. Electronic address: lir9065@med.cornell.edu. 2. Department of Cardiology/Medicine, Weill Cornell Medicine/New York Presbyterian, New York, NY. 3. Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY. 4. Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York Presbyterian, New York, NY.
Abstract
OBJECTIVE: Whereas left atrial (LA) strain has been well-validated using transthoracic echocardiography (TTE), its detection using transesophageal echocardiography (TEE) has not been studied. Conventional transesophageal views are known to be limited due to the posterior location of the LA. Here, the feasibility and accuracy of the deep transgastric long-axis LA focused view for peak atrial longitudinal strain (PALS) quantification was tested. DESIGN: This was a retrospective study of patients who underwent elective cardiac surgery between 2018 and 2020. TEE deep transgastric long-axis view was compared to TTE 4-chamber atrial focused view as the reference standard. LA area, volume, and PALS were quantified independently. SETTING: At Weill Cornell Medicine, a single, large academic medical center. PARTICIPANTS: The population comprised 42 patients undergoing cardiac surgery who had a TTE and TEE within 14.9 ± 20.8 days. INTERVENTIONS: TTE, TEE, and cardiac surgery. MEASUREMENTS AND MAIN RESULTS: TEE-derived PALS strongly correlated with TTE- derived PALS (r = 0.92, p < 0.001), though absolute PALS were lower (20.7 ± 6.0% v 25.7 ± 6.8%; p < 0.001). Mean TEE-derived atrial length was similar to TTE-derived length (5.18 ± 0.61 cm v 5.24 ± 0.61 cm; p = 0.38), but mean LA area was significantly smaller (16.7 ± 3.5 cm2v 18.9 ± 3.7 cm2; p < 0.001), with significant correlations between the 2 modalities for both (r = 0.74, 0.74, respectively; all p < 0.001). CONCLUSION: This exploratory study supported the feasibility of TEE for assessing LA longitudinal strain. There was an excellent correlation between atrial strain derived via TEE versus TTE, although values tended to be smaller on TEE, and bias between values was highly variable, suggesting that the values were not interchangeable.
OBJECTIVE: Whereas left atrial (LA) strain has been well-validated using transthoracic echocardiography (TTE), its detection using transesophageal echocardiography (TEE) has not been studied. Conventional transesophageal views are known to be limited due to the posterior location of the LA. Here, the feasibility and accuracy of the deep transgastric long-axis LA focused view for peak atrial longitudinal strain (PALS) quantification was tested. DESIGN: This was a retrospective study of patients who underwent elective cardiac surgery between 2018 and 2020. TEE deep transgastric long-axis view was compared to TTE 4-chamber atrial focused view as the reference standard. LA area, volume, and PALS were quantified independently. SETTING: At Weill Cornell Medicine, a single, large academic medical center. PARTICIPANTS: The population comprised 42 patients undergoing cardiac surgery who had a TTE and TEE within 14.9 ± 20.8 days. INTERVENTIONS: TTE, TEE, and cardiac surgery. MEASUREMENTS AND MAIN RESULTS: TEE-derived PALS strongly correlated with TTE- derived PALS (r = 0.92, p < 0.001), though absolute PALS were lower (20.7 ± 6.0% v 25.7 ± 6.8%; p < 0.001). Mean TEE-derived atrial length was similar to TTE-derived length (5.18 ± 0.61 cm v 5.24 ± 0.61 cm; p = 0.38), but mean LA area was significantly smaller (16.7 ± 3.5 cm2v 18.9 ± 3.7 cm2; p < 0.001), with significant correlations between the 2 modalities for both (r = 0.74, 0.74, respectively; all p < 0.001). CONCLUSION: This exploratory study supported the feasibility of TEE for assessing LA longitudinal strain. There was an excellent correlation between atrial strain derived via TEE versus TTE, although values tended to be smaller on TEE, and bias between values was highly variable, suggesting that the values were not interchangeable.
Authors: Lisa Q Rong; Maria C Palumbo; Mohammed Rahouma; Alexandra J Lopes; Richard B Devereux; Jiwon Kim; Leonard N Girardi; Mario Gaudino; Jonathan W Weinsaft Journal: Echocardiography Date: 2020-09-10 Impact factor: 1.724
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Authors: Jiwon Kim; Brian Yum; Maria C Palumbo; Razia Sultana; Nathaniel Wright; Mukund Das; Cindy You; Chaya S Moskowitz; Robert A Levine; Richard B Devereux; Jonathan W Weinsaft Journal: JACC Cardiovasc Imaging Date: 2020-08-19
Authors: Alina Nicoara; Nikolaos Skubas; Niv Ad; Alan Finley; Rebecca T Hahn; Feroze Mahmood; Sunil Mankad; Charles B Nyman; Francis Pagani; Thomas R Porter; Kent Rehfeldt; Marc Stone; Bradley Taylor; Annette Vegas; Karen G Zimmerman; William A Zoghbi; Madhav Swaminathan Journal: J Am Soc Echocardiogr Date: 2020-06 Impact factor: 5.251
Authors: Lisa Q Rong; Brian Yum; Christiane Abouzeid; Maria Chiara Palumbo; Lillian R Brouwer; Richard B Devereux; Leonard N Girardi; Jonathan W Weinsaft; Mario Gaudino; Jiwon Kim Journal: Cardiovasc Ultrasound Date: 2019-06-07 Impact factor: 2.062