Left Atrial Strain as a New Noninvasive Parameter for Assessment of Left Ventricle End-diastolic Pressure

Background: Recent facts express diastolic function as a very important aspect of the functional and health status of the heart rendering diastolic function assessment a priority. Objectives: In this study, we explored the validity of left atrial strain as a new trustful parameter in diastolic function assessments. Materials and Methods: Forty eligible patients were selected among patients who were already scheduled to undergo elective diagnostic coronary angiography for suspected or confirmed coronary artery disease. Any patient with significant mitral or aortic disease, prosthetic valve, acute coronary syndrome (STEMI or non-STEMI), malignant arrhythmias, or atrial arrhythmias were excluded. Left Ventricle end-diastolic pressure (LVEDP) was measured for all patients during left-side catheterization with an echocardiographic study done within 3 h before or after catheterization. Diastolic function assessment performed according to the 2016 ASE/EACVI recommendation and LA strain were the main part of the echo study. Results: The left atrial strain reservoir phase showed 88.9% sensitivity, 86.4% specificity, and 87.5 accuracy with a cutoff value of 26.5 for the detection of patients with elevated LVEDP > 16 mm Hg, while sensitivity specificity and accuracy were 83.3%, 77.3%, and 80% respectively for conduit phase and 83.3%, 95.5% and 90% respectively for contractile phase. Conclusion: LA strain in all its three phases shows good validity in the assessment of left ventricle diastolic dysfunction with good sensitivity, specificity, and accuracy and could be used in adjuvant to the 2016 guideline algorithm for LVDD assessment.