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).