Background
The diagnosis of Heart failure (HF) with preserved ejection fraction
(HFpEF) is based on the presence of preserved left ventricle (LV)
ejection fraction (EF) with evidence of advanced diastolic dysfunction
in the absence of cardiac or non cardiac conditions that could cause HF
symptoms [1,2,3]. However, diagnosis
of diastolic dysfunction is challenging as it can only done by invasive
catheterization. In the other hand , in daily practice echocardiography
is the main noninvasive method used to role in the diagnosis and role
out other cardiac conditions [4,
5]. Several echocardiographic parameters
were suggested to define and grade diastolic
function[6] . Unfortunately, these
parameters are discrepant in many patients, and thus diastolic function
is indeterminate [6].
Left atrial (LA) function assessment had recently undergone a
renaissance, as its assessment has become easier to perform.
Contemporary myocardial mechanics using echocardiographic 2D speckle
tracking allows for measurement of LA left strain and volume changes
throughout the cardiac cycle. It is able to measure phasic atrial
volumes in the various phases of diastole (reservoir, passive, conduit
and active), that directly represent LV filling. Given the close
interplay between the LA and LV left, LA function analysis is actually a
functional analysis of LV filling that may improve our understanding of
the left ventricular diastolic physiology and prove valuable in the
diagnosis of diastolic dysfunction [7,
8].
The purpose of our study to assess whether left atrial function may
contribute to LV filling evaluation in patients with indeterminate
diastolic function (IndtDFx).