The prognostic value of left atrial strain in diastolic function response to exercise stress echocardiography / 中华超声影像学杂志

ABSTRACT

Objective:To study the prognostic value of left atrial strain in diastolic function response by treadmill exercise stress echocardiography.Methods:During May 2018 to February 2019, 64 patients underwent treadmill exercise stress echocardiography for diastolic function evaluation in Tangdu Hospital, Air Force Medical University, were recruited.Patients were categorized into diastolic stress test negative group (pre-stress E/e′ <14 & post-stress E/e′<14) (DST- group), and diastolic stress test positive group (pre-stress E/e′ <14 & post-stress E/e′>14) (DST+ group). Patients′ characteristics of the stress test, left ventricular diameter, left atrial volume index, systolic and diastolic function, and left atrial strain parameters were compared between these two groups. ROC analyses were performed based on the echocardiographic parameters with significant group differences ( P<0.01) to determine the predictive values for diastolic stress test response. Results:The pre-stress E/e′ and left atrial strain parameters were significantly differently between DST- and DST+ group. The DST- showed significantly lower E/e′ (8.20±1.27 vs 10.32±1.33, P<0.01), but higher left atrial strains than DST+ group[reservoir function(33.7±5.7)% vs (26.5±5.5)%, P<0.01; conduit function(16.8±4.0)% vs (11.8±3.4)%, P<0.01; pump function(16.9±5.7)% vs (14.7±5.5)%, P<0.05]. The left atrial reservoir function, conduit function and pre-stress E/e′ could predict the diastolic stress test response, the areas under ROC curve were 0.81 ( P<0.01), 0.62 ( P=0.04) and 0.71 ( P<0.01). Conclusions:The left atrial strain parameters under resting condition could predict the diastolic stress test response. It may serve as an alternative method of exercise stress echocardiography for diastolic function evaluation.