Skip to main content
Top
Published in: Cardiovascular Ultrasound 1/2015

Open Access 01-12-2015 | Research

Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography

Authors: Jiaqi Shen, Qiao Zhou, Yue Liu, Runlan Luo, Bijun Tan, Guangsen Li

Published in: Cardiovascular Ultrasound | Issue 1/2015

Login to get access

Abstract

Background

Iron-deficiency anemia (IDA) is a global health problem and a common medical condition that can be seen in everyday clinical practice. And two-dimensional speckle tracking echocardiography (2D-STE) has been reported very useful in evaluating left atrial (LA) function, as well as left ventricular (LV) function. The aim of our study is to evaluate the LA function in patients with IDA by 2D-STE.

Methods

65 patients with IDA were selected. This group of patients was then divided into two groups according to the degree of hemoglobin: group B (Hb > 90 g/L) and group C (Hb60 ~ 90 g/L). Another 30 healthy people were also selected as control group A. Conventional echocardiography parameters, such as left atrial diameter (LAD), peak E and A of mitralis (E, A), E/A, end-diastolic thickness of ventricular septum (IVST d), end-diastolic thickness of LV posterior wall (PWTd) and left ventricular end-diastolic dimension (LVDd) were obtained from these three groups. Left atrial minimum volume (LAVmin), left atrial pre-atrial contraction volume (LAVp) and left atrial maximum volume (LAVmax) were measured by Simpson’s rule, whereas left atrial active ejection fraction (LAAEF) and left atrial passive ejection fraction (LAPEF) were obtained from calculation. Two-dimensional images were acquired from apical four-chamber view and two-chamber view to store images for offline analysis. The global peak atrial longitudinal strain and strain rate of systolic LV (GLSs, GLSRs) as well as early and late diastolic LV strain rate (GLSRe, GLSRa) curves of LA were acquired in each LA segment from basal segment to top segment of LA by 2D-STE.

Results

Compared with group A, there were no differences between group B and group A (all P > 0.05). The LAAEF and GLSRa were significantly higher in group C compared with those of group A and group B (all P < 0.01). The LAPEF, GLSs, GLSRs and GLSRe were significantly lower in group C compared with those of group A and group B (all P < 0.01).

Conclusions

2D-STE could evaluate the LA function in patients with IDA.
Literature
1.
go back to reference Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging? Semin Hematol. 2015;52(4):261–9.CrossRefPubMed Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging? Semin Hematol. 2015;52(4):261–9.CrossRefPubMed
3.
go back to reference McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr. 2009;12(4):444–54.CrossRefPubMed McLean E, Cogswell M, Egli I, Wojdyla D, de Benoist B. Worldwide prevalence of anaemia, WHO Vitamin and Mineral Nutrition Information System, 1993–2005. Public Health Nutr. 2009;12(4):444–54.CrossRefPubMed
4.
go back to reference Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, Regan M, Weatherall D, Chou DP, Eisele TP, Flaxman SR, Pullan RL, Brooker SJ, Murray CJ. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615–24.CrossRefPubMedPubMedCentral Kassebaum NJ, Jasrasaria R, Naghavi M, Wulf SK, Johns N, Lozano R, Regan M, Weatherall D, Chou DP, Eisele TP, Flaxman SR, Pullan RL, Brooker SJ, Murray CJ. A systematic analysis of global anemia burden from 1990 to 2010. Blood. 2014;123(5):615–24.CrossRefPubMedPubMedCentral
5.
go back to reference Pasricha SR, Drakesmith H, Black J, Hipgrave D, Biggs BA. Control of iron deficiency anemia in low- and middle-income countries. Blood. 2013;121(14):2607–17.CrossRefPubMed Pasricha SR, Drakesmith H, Black J, Hipgrave D, Biggs BA. Control of iron deficiency anemia in low- and middle-income countries. Blood. 2013;121(14):2607–17.CrossRefPubMed
7.
go back to reference Georgieva Z, Georgieva M. Compensatory and adaptive changes in microcirculation and left ventricular function of patients with chronic iron-deficiency anaemia. Clin Hemorheol Microcirc. 1997;17(1):21–30.PubMed Georgieva Z, Georgieva M. Compensatory and adaptive changes in microcirculation and left ventricular function of patients with chronic iron-deficiency anaemia. Clin Hemorheol Microcirc. 1997;17(1):21–30.PubMed
8.
go back to reference Rakusan K, Cicutti N, Kolar F. Effect of anemia on cardiac function, microvascular structure, and capillary hematocrit in rat hearts. Am J Physiol Heart Circ Physiol. 2001;280(3):1407–14. Rakusan K, Cicutti N, Kolar F. Effect of anemia on cardiac function, microvascular structure, and capillary hematocrit in rat hearts. Am J Physiol Heart Circ Physiol. 2001;280(3):1407–14.
9.
go back to reference Blume GG, Mcleod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, Tsang TS. Left atrial function: Physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12(6):421–30.CrossRefPubMed Blume GG, Mcleod CJ, Barnes ME, Seward JB, Pellikka PA, Bastiansen PM, Tsang TS. Left atrial function: Physiology, assessment, and clinical implications. Eur J Echocardiogr. 2011;12(6):421–30.CrossRefPubMed
10.
go back to reference Amin MG, Tighiouart H, Weiner DE, Stark PC, Griffith JL, MacLeod B, Salem DN, Sarnak MJ. Hematocrit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol. 2004;43(7):1276–82.CrossRefPubMed Amin MG, Tighiouart H, Weiner DE, Stark PC, Griffith JL, MacLeod B, Salem DN, Sarnak MJ. Hematocrit and left ventricular mass: the Framingham Heart study. J Am Coll Cardiol. 2004;43(7):1276–82.CrossRefPubMed
11.
go back to reference Cameli M, Lisi M, Righini FM, Mondillo S. Novel echocardiographic techniques to assess left atrial size,anatomy and function. Cardiovasc Ultrasound. 2012;10:4.CrossRefPubMedPubMedCentral Cameli M, Lisi M, Righini FM, Mondillo S. Novel echocardiographic techniques to assess left atrial size,anatomy and function. Cardiovasc Ultrasound. 2012;10:4.CrossRefPubMedPubMedCentral
12.
go back to reference Cianciulli TF, Saccheri MC, Lax JA, Bermann AM, Ferreiro DE. Two-dimensional speckle tracking echocardiography for the assessment of atrial function. World J Cardiol. 2010;2(7):163–70.CrossRefPubMedPubMedCentral Cianciulli TF, Saccheri MC, Lax JA, Bermann AM, Ferreiro DE. Two-dimensional speckle tracking echocardiography for the assessment of atrial function. World J Cardiol. 2010;2(7):163–70.CrossRefPubMedPubMedCentral
13.
go back to reference Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, Bernazzali S, Maccherini M. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;21(8):14.CrossRef Cameli M, Lisi M, Mondillo S, Padeletti M, Ballo P, Tsioulpas C, Bernazzali S, Maccherini M. Left atrial longitudinal strain by speckle tracking echocardiography correlates well with left ventricular filling pressures in patients with heart failure. Cardiovasc Ultrasound. 2010;21(8):14.CrossRef
14.
go back to reference Galderisi M, Henein MY, D’hooge J, Sicari R, Badano LP, Zamorano JL, Roelandt JR. Recommendations of the European Association of Echocardiography: How to use echo-Doppler in clinical trials: Different modalities for different purposes. Eur J Echocardiogr. 2011;12(5):339–53.CrossRefPubMed Galderisi M, Henein MY, D’hooge J, Sicari R, Badano LP, Zamorano JL, Roelandt JR. Recommendations of the European Association of Echocardiography: How to use echo-Doppler in clinical trials: Different modalities for different purposes. Eur J Echocardiogr. 2011;12(5):339–53.CrossRefPubMed
15.
go back to reference Yoon YE, Kim HJ, Kim SA, Kim SH, Park JH, Park KH, Choi S, Kim MK, Kim HS, Cho GY. Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation. Cardiovasc Ultrasound. 2012;20(3):140–5.CrossRef Yoon YE, Kim HJ, Kim SA, Kim SH, Park JH, Park KH, Choi S, Kim MK, Kim HS, Cho GY. Left atrial mechanical function and stiffness in patients with paroxysmal atrial fibrillation. Cardiovasc Ultrasound. 2012;20(3):140–5.CrossRef
16.
go back to reference Moyssakis I, Papadopoulos DP, Kelepeshis G, Gialafos E, Votteas V, Triposkiadis F. Left atrial systolic reserve inidiopathic vs. ischaemic-dilated cardiomyopathy. Eur J ClinInvest. 2005;35(6):355–61.CrossRef Moyssakis I, Papadopoulos DP, Kelepeshis G, Gialafos E, Votteas V, Triposkiadis F. Left atrial systolic reserve inidiopathic vs. ischaemic-dilated cardiomyopathy. Eur J ClinInvest. 2005;35(6):355–61.CrossRef
17.
go back to reference Paraskevaidis IA, Dodouras T, Adamopoulos S, Kremastinos DT. Left atrial functional reserve in patients with nonischemic dilated cardiomyopathy: an echocardiographic dobutamine study. Chest. 2002;122(4):1340–7.CrossRefPubMed Paraskevaidis IA, Dodouras T, Adamopoulos S, Kremastinos DT. Left atrial functional reserve in patients with nonischemic dilated cardiomyopathy: an echocardiographic dobutamine study. Chest. 2002;122(4):1340–7.CrossRefPubMed
18.
go back to reference Komajda M, Anker SD, Charlesworth A, Okonko D, Metra M, Di Lenarda A, Remme W, Moullet C, Swedberg K, Cleland JG, Poole-Wilson PA. The impact of new onset anaemia on morbidity and mortality inchronic heart failure: results from COMET. Eur Heart J. 2006;27(12):1440–6.CrossRefPubMed Komajda M, Anker SD, Charlesworth A, Okonko D, Metra M, Di Lenarda A, Remme W, Moullet C, Swedberg K, Cleland JG, Poole-Wilson PA. The impact of new onset anaemia on morbidity and mortality inchronic heart failure: results from COMET. Eur Heart J. 2006;27(12):1440–6.CrossRefPubMed
19.
go back to reference Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J Gastrointest Pathophysiol. 2015;6(3):62–72.PubMedPubMedCentral Kaitha S, Bashir M, Ali T. Iron deficiency anemia in inflammatory bowel disease. World J Gastrointest Pathophysiol. 2015;6(3):62–72.PubMedPubMedCentral
20.
go back to reference Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, Cha SS, Seward JB. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol. 2006;47(5):1018–23.CrossRefPubMed Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, Cha SS, Seward JB. Prediction of cardiovascular outcomes with left atrial size: is volume superior to area or diameter? J Am Coll Cardiol. 2006;47(5):1018–23.CrossRefPubMed
21.
go back to reference Laukkanen JA, Kurl S, Eränen J, Huttunen M, Salonen JT. Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med. 2005;165(15):1788–93.CrossRefPubMed Laukkanen JA, Kurl S, Eränen J, Huttunen M, Salonen JT. Left atrium size and the risk of cardiovascular death in middle-aged men. Arch Intern Med. 2005;165(15):1788–93.CrossRefPubMed
22.
go back to reference Hong J, Gu X, An P, Luo T, Lv Q, Kang J, He Y, Hu R, Liu X, Ma C. Left atrial functional remodeling in lone atrial fibrillation: a two-dimensional speckle tracking echocardiographic study. Echocardiography. 2013;30(9):1051–60.PubMed Hong J, Gu X, An P, Luo T, Lv Q, Kang J, He Y, Hu R, Liu X, Ma C. Left atrial functional remodeling in lone atrial fibrillation: a two-dimensional speckle tracking echocardiographic study. Echocardiography. 2013;30(9):1051–60.PubMed
23.
go back to reference Miyoshi H, Oishi Y, Mizuguchi Y, Iuchi A, Nagase N, Ara N, Oki T. Effect of anincrease in left ventricular pressure overload on left atrialleftventricular coupling in patients with hypertension: Atwo-dimensional speckle tracking echocardiographicstudy. Echocardiography. 2013;30(6):658–66.CrossRefPubMed Miyoshi H, Oishi Y, Mizuguchi Y, Iuchi A, Nagase N, Ara N, Oki T. Effect of anincrease in left ventricular pressure overload on left atrialleftventricular coupling in patients with hypertension: Atwo-dimensional speckle tracking echocardiographicstudy. Echocardiography. 2013;30(6):658–66.CrossRefPubMed
24.
go back to reference Kim D, Shim CY, Cho IJ, Kim YD, Nam HS, Chang HJ, Hong GR, Ha JW, Heo JH, Chung N. Incremental value of left atrial global longitudinal strain for prediction of post stroke atrial fibrillation in patients with acute ischemic stroke. Cardiovasc Ultrasound. 2016;24(1):20–7.CrossRef Kim D, Shim CY, Cho IJ, Kim YD, Nam HS, Chang HJ, Hong GR, Ha JW, Heo JH, Chung N. Incremental value of left atrial global longitudinal strain for prediction of post stroke atrial fibrillation in patients with acute ischemic stroke. Cardiovasc Ultrasound. 2016;24(1):20–7.CrossRef
25.
go back to reference Shao C, Zhu J, Chen J, Xu W. Independent prognostic value of left atrial function by two-dimensional speckle tracking imaging in patients with non -ST-segment-elevation acute myocardial infarction. BMC Cardiovasc Disord. 2015;15:145.CrossRefPubMedPubMedCentral Shao C, Zhu J, Chen J, Xu W. Independent prognostic value of left atrial function by two-dimensional speckle tracking imaging in patients with non -ST-segment-elevation acute myocardial infarction. BMC Cardiovasc Disord. 2015;15:145.CrossRefPubMedPubMedCentral
26.
go back to reference Morris DA, Gailani M, Vaz Pérez A, Blaschke F, Dietz R, Haverkamp W, Ozcelik C. Left atrial systolic and diastolic dysfunction in heart failure with normal left ventricular ejection fraction. J Am Soc Echocardiogr. 2011;24(6):651–62.CrossRefPubMed Morris DA, Gailani M, Vaz Pérez A, Blaschke F, Dietz R, Haverkamp W, Ozcelik C. Left atrial systolic and diastolic dysfunction in heart failure with normal left ventricular ejection fraction. J Am Soc Echocardiogr. 2011;24(6):651–62.CrossRefPubMed
27.
go back to reference Santos AB, Kraigher-Krainer E, Gupta DK, Claggett B, Zile MR, Pieske B, Voors AA, Lefkowitz M, Bransford T, Shi V, Packer M, McMurray JJ, Shah AM, Solomon SD. Impaired left atrial function in heart failure with preserved ejection fraction. Eur J Heart Fail. 2014;16(10):1096–103.CrossRefPubMed Santos AB, Kraigher-Krainer E, Gupta DK, Claggett B, Zile MR, Pieske B, Voors AA, Lefkowitz M, Bransford T, Shi V, Packer M, McMurray JJ, Shah AM, Solomon SD. Impaired left atrial function in heart failure with preserved ejection fraction. Eur J Heart Fail. 2014;16(10):1096–103.CrossRefPubMed
28.
go back to reference Kocabay G, Karabay CY, Colak Y, Oduncu V, Kalayci A, Akgun T, Guler A, Kirma C. Left atrial deformation parameters in patients with non-alcoholic fatty liver disease: A 2D speckle tracking imaging study. Clin Sci (Lond). 2014;126(4):297–304.CrossRef Kocabay G, Karabay CY, Colak Y, Oduncu V, Kalayci A, Akgun T, Guler A, Kirma C. Left atrial deformation parameters in patients with non-alcoholic fatty liver disease: A 2D speckle tracking imaging study. Clin Sci (Lond). 2014;126(4):297–304.CrossRef
29.
go back to reference Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S, Otsuji Y, Lang RM. Effects of aging on left atrialfunction assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogra. 2009;22(1):70–5.CrossRef Okamatsu K, Takeuchi M, Nakai H, Nishikage T, Salgo IS, Husson S, Otsuji Y, Lang RM. Effects of aging on left atrialfunction assessed by two-dimensional speckle tracking echocardiography. J Am Soc Echocardiogra. 2009;22(1):70–5.CrossRef
30.
go back to reference Rabbat MG, Wilber D, Thomas K, Malick O, Bashir A, Agrawal A, Biswas S, Sanagala T, Syed MA. Left atrial volume assessment in atrial fibrillation using multimodalityimaging: a comparison of echocardiography, invasive three-dimensional CARTO and cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2015;31(5):1011–8.CrossRefPubMed Rabbat MG, Wilber D, Thomas K, Malick O, Bashir A, Agrawal A, Biswas S, Sanagala T, Syed MA. Left atrial volume assessment in atrial fibrillation using multimodalityimaging: a comparison of echocardiography, invasive three-dimensional CARTO and cardiac magnetic resonance imaging. Int J Cardiovasc Imaging. 2015;31(5):1011–8.CrossRefPubMed
31.
go back to reference Barbier P, Solomon SB, Schiller NB, Glantz SA. Left atrial relaxation and left ventricular systolic functiondetermine left atrial reservoir function. Circulation. 1999;100(4):427–36.CrossRefPubMed Barbier P, Solomon SB, Schiller NB, Glantz SA. Left atrial relaxation and left ventricular systolic functiondetermine left atrial reservoir function. Circulation. 1999;100(4):427–36.CrossRefPubMed
32.
go back to reference Tadic M, Ilic S, Cuspidi C, Ivanovic B, Bukarica L, Kostic N, Marjanovic T, Kocijancic V, Celic V. Left and right atrialphasic function and deformation in untreated patients with prediabetes and type 2 diabetes mellitus. Int J Cardiovasc Imaging. 2015;31(1):65–76.CrossRefPubMed Tadic M, Ilic S, Cuspidi C, Ivanovic B, Bukarica L, Kostic N, Marjanovic T, Kocijancic V, Celic V. Left and right atrialphasic function and deformation in untreated patients with prediabetes and type 2 diabetes mellitus. Int J Cardiovasc Imaging. 2015;31(1):65–76.CrossRefPubMed
33.
go back to reference Wakami K, Ohte N, Asada K, Fukuta H, Goto T, Mukai S, Narita H, Kimura G. Correlation between left ventricular enddiastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009;22(7):847–51.CrossRefPubMed Wakami K, Ohte N, Asada K, Fukuta H, Goto T, Mukai S, Narita H, Kimura G. Correlation between left ventricular enddiastolic pressure and peak left atrial wall strain during left ventricular systole. J Am Soc Echocardiogr. 2009;22(7):847–51.CrossRefPubMed
34.
go back to reference Anwar AM, Geleijnse ML, Soliman OI, Nemes A, ten Cate FJ. Left atrial Frank-Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes. Heart. 2007;93(11):1393–7.CrossRefPubMedPubMedCentral Anwar AM, Geleijnse ML, Soliman OI, Nemes A, ten Cate FJ. Left atrial Frank-Starling law assessed by real-time, three-dimensional echocardiographic left atrial volume changes. Heart. 2007;93(11):1393–7.CrossRefPubMedPubMedCentral
35.
go back to reference Sasaki S, Watanabe T, Tamura H, Nishiyama S, Wanezaki M, Sato C, Yamaura G, Ishino M, Arimoto T, Takahashi H, Shishido T, Miyamoto T, Kubota I. Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atria. Appendage dysfunction in patients with acute ischemic stroke. BBA Clin. 2014;28(2):40–7.CrossRef Sasaki S, Watanabe T, Tamura H, Nishiyama S, Wanezaki M, Sato C, Yamaura G, Ishino M, Arimoto T, Takahashi H, Shishido T, Miyamoto T, Kubota I. Left atrial strain as evaluated by two-dimensional speckle tracking predicts left atria. Appendage dysfunction in patients with acute ischemic stroke. BBA Clin. 2014;28(2):40–7.CrossRef
Metadata
Title
Evaluation of left atrial function in patients with iron-deficiency anemia by two-dimensional speckle tracking echocardiography
Authors
Jiaqi Shen
Qiao Zhou
Yue Liu
Runlan Luo
Bijun Tan
Guangsen Li
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2015
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/s12947-016-0078-z

Other articles of this Issue 1/2015

Cardiovascular Ultrasound 1/2015 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.