Association of Left Atrial Myocardial Function With Left Ventricular Diastolic Dysfunction in Subjects With Preserved Systolic Function: A Strain Rate Imaging Study

BACKGROUND: The purpose of this study was to investigate the relationship between left atrial (LA) myocardial function and left ventricular (LV) diastolic dysfunction in subjects with preserved LV ejection fraction (LVEF). METHODS: The study included a group of 118 hypertensive patients and normal subjects. LV diastolic dysfunction was classified into 4 groups: none, mild, moderate, and severe. Peak strain rates in systole (S-Sr), early diastole (E-Sr), and late diastole (A-Sr) were obtained from Doppler-derived strain rate imaging to evaluate LA myocardial deformation. RESULTS: No significant difference in LA dimension was observed in subjects with different degrees of LV diastolic dysfunction, although LA myocardial strain rate parameters were all significantly different across the 4 groups (all with P < 0.001). Compared with patients of normal diastolic function, the mild diastolic dysfunction group had significantly lower E-Sr (0.62 ± 0.18 s⁻¹ vs 1.20 ± 0.38 s⁻¹, P < 0.001) and S-Sr (0.78 ± 0.16 s⁻¹ vs 0.94 ± 0.22 s⁻¹, P < 0.001) but increased A-Sr (1.14 ± 0.29 s⁻¹ vs 1.00 ± 0.23 s⁻¹, P = 0.05). CONCLUSIONS: By using strain rate imaging, significant changes of LA deformation in response to different stages of LV diastolic dysfunction were detected in subjects with preserved LVEF. Quantification of LA myocardial function rather than LA size may have the potential to predict early LV diastolic dysfunction in subjects with preserved LVEF.