What does this research mean for the field?

Q: What does this research mean for the field?

Reduced left atrial contractile strain and increased left atrial stiffness index (LASI) are significant predictors of abnormal plasma NTproBNP levels in asymptomatic individuals with normal ejection fraction and normal left atrial volume. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

November 26, 2022Cardiovascular UltrasoundOpen Access

Reduced left atrial contractile strain with speckle tracking analysis predicts abnormal plasma NTproBNP in an asymptomatic community population

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Why the study?

The relationship between global LA deformation parameters and plasma NTproBNP levels in asymptomatic community residents with normal ejection fraction and normal LA volume was not well explored.

Does left atrial contractile strain predict abnormal plasma NTproBNP in an asymptomatic community population with normal ejection fraction and LA volume?

Structured PICO

Does left atrial contractile strain predict abnormal plasma NTproBNP in an asymptomatic community population with normal ejection fraction and LA volume?

Population

Asymptomatic community residents with normal ejection fraction and normal LA volume in Beijing. 117 individuals had increased plasma NTproBNP (≥ 125 pg/ml).

Intervention

Two-dimensional speckle tracking strain and strain rate (SR) imaging (LA reservoir and contractile strain, LA stiffness index)

Comparator

Normal vs abnormal NTproBNP levels

Outcome

Relationship between global LA deformation parameters and plasma NTproBNP levelssurrogate

Left atrial contractile strain and stiffness index assessed by speckle tracking echocardiography can predict elevated NTproBNP levels in asymptomatic individuals with normal ejection fraction.

Implication

Hypothesis-generating for LASI in detecting elevated NTproBNP; prospective studies needed before clinical adoption.

Abstract

BACKGROUND: The left atrium (LA) is closely related to left ventricular diastolic function. Two-dimensional speckle tracking strain and strain rate (SR) imaging has been applied in the study of LA function. We intended to explore the relationship between global LA deformation parameters and plasma NTproBNP levels in asymptomatic community residents with normal ejection fraction and normal LA volume. METHODS: A cross-sectional sample of Beijing residents underwent comprehensive Doppler echocardiography and medical record review in 2009. Global LA longitudinal strain and SR indexes were obtained in the apical four-chamber view. LA stiffness index (LASI) was calculated as the ratio of early diastolic velocity of transmitral flow/early diastolic mitral annular motion velocity (E/E') to LA reservoir strain. RESULTS: ) were investigated in our study. 117 individuals had increased plasma NTproBNP (≥ 125 pg/ml). LA reservoir and contractile function by LA strain and SR indexes were significantly reduced in the abnormal NTproBNP group compared with the normal NTproBNP group. Multiple regression analysis indicated that LA contractile strain was a negative predictor of plasma NTproBNP in addition to indexed LA volume and E/E'. LASI was higher in the abnormal NTproBNP group and was significantly correlated with NTproBNP (r = 0.342, P < 0.001). The area under ROC analysis for LASI in predicting elevated plasma NTproBNP was 0.690, similar with LA contractile strain, E/E' and LAVI. The cut-off value of LASI was 0.612. CONCLUSIONS: LA reservoir and contractile functions demonstrated by LA strain and SR were significantly impaired in the community-based population with increased plasma NTproBNP levels. LA contractile strain adds incremental information in predicting abnormal NTproBNP levels. As a single index, LASI showed similar diagnostic value with LAVI and E/E' in predicting abnormal NTproBNP.