THE LEFT ATRIAL FUNCTIONS AND THE ESTIMATED PULMONARY VASCULAR
RESISTANCE IN REDUCED EJECTION FRACTION HEART FAILURE PATIENTS :
ASSESSMENT ACCORDING TO DIASTOLIC DYSFUNCTION GRADES
Abstract
Aim : In this study , according to the diagnosed left ventricular
diastolic dysfunction (LVDD) grades, we aimed to determine the
correlation of the 2D speckle tracking echocardiography (2DSTE) derived
left atrial functional parameters and echocardiographic right
ventricular (RV) systolic functions and pulmonary vascular resistance
(PVR) estimates in reduced ejection fraction heart failure patients
(HFrEF). Methods : Dilated cardiomyopathy patients with an EF lower than
40% included. Echocardiographic examinations including PVR calculations
and the 2DSTE performed ; LASr: left atrial reservoir strain , LAScd:
left atrial conduit strain, LASct: left atrial contraction strain were
calculated. LVDD grading was performed according to guidelines. Results:
The mean EF was 28.8 ± 6.0 %. The estimated PVR was strongly correlated
with LASr, LAScd and LASct (p<0,0001 for each parameter) . All
of the LA strain parameters were in decreasing trend along with the
increased LVDD grades. The LASct were lower in Grade III when compared
with the Grade II LVDD (p<0.01) . Conclusion: The decrease of
LA contraction function in Grade 3 diastolic dysfunction is evident and
it may be associated with the extent of LA remodelling in these
patients. PVR estimates well correlates with the LA strain parameters.
Future studies may evaluate the value of estimated PVR for grading of
LVDD.