Left Atrial Function: an Overlooked Metrics in Clinical Routine Echocardiography
Key result
Left atrial reservoir strain provides additive value in diagnosing heart failure with preserved ejection fraction, demonstrating high specificity (94%) but relatively low sensitivity (56%).
Why the study?
Does left atrial reservoir strain improve the diagnostic accuracy for HFpEF in patients with unexplained dyspnoea?
Population
Patients presenting with unexplained dyspnoea evaluated for heart failure with preserved ejection fraction
Comparison
Left atrial reservoir strain and LA stiffness… vs Recommended conventional echocardiographic…
Design
Editorial
Authors
Discussion
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Implication
Left atrial reservoir strain improves the diagnostic evaluation of HFpEF, though resting echocardiographic measurements may lack sensitivity compared to exercise stress testing.
Structured PICO
Does left atrial reservoir strain improve the diagnostic accuracy for HFpEF in patients with unexplained dyspnoea?
P
Population
Patients presenting with unexplained dyspnoea evaluated for heart failure with preserved ejection fraction (HFpEF)
E
Exposure
Left atrial reservoir strain and LA stiffness index measured by echocardiography
C
Comparator
Recommended conventional echocardiographic parameters used to diagnose HFpEF
O
Outcome
Diagnostic accuracy for HFpEF (confirmed or refuted using maximal-effort invasive exercise assessment)surrogate
Left atrial reservoir strain improves the diagnostic evaluation of HFpEF, though resting echocardiographic measurements may lack sensitivity compared to exercise stress testing.
Limitations
- Echocardiographic measurements were obtained only at rest while wedge pressure was measured during exercise.
- Cardiac catheterization and echocardiographic imaging were not simultaneous (median delay of 6 days).
- Lack of robust clinical outcome data from large prospective multicentre trials.
- Lack of age- and sex-adjusted normal reference data on a larger scale.
- Echocardiographic measurements obtained only at rest while reference was exercise wedge pressure
- Cardiac catheterization and echocardiographic imaging were not simultaneous (median delay of 6 days)
- Changes in management between tests could alter echocardiographic indices
Cite This Study
Badano et al. (2019) conducted an editorial in Heart failure with preserved ejection fraction (HFpEF). Left atrial strain assessment was evaluated. Left atrial reservoir strain provides additive value in diagnosing heart failure with preserved ejection fraction, demonstrating high specificity (94%) but relatively low sensitivity (56%).