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

Open Access 01-12-2015 | Research article

Independent prognostic value of left atrial function by two-dimensional speckle tracking imaging in patients with non -ST-segment-elevation acute myocardial infarction

Authors: Chunlai Shao, Jing Zhu, Jianchang Chen, Weiting Xu

Published in: BMC Cardiovascular Disorders | Issue 1/2015

Login to get access

Abstract

Background

The objective of this study is to evaluate left atrial(LA) function and its prognostic value by two-dimensional speckle tracking echocardiography (STE) in patients with non-ST-segment-elevation acute myocardial infarction (NSTEAMI).

Methods

Global longitudinal LA S/SR data obtained by 2D speckle imaging with automated software (Echo PAC, GE Medical).

Results

Clinical variables and angiographic, echocardiographic, and STE parameters were studied in 65 patients with NSTEAMI (51 males and 14 females; mean age of 60.7 ± 9.8 years) who underwent elective PCI. The final study population consisted of 51 individuals (43 males and 8 females; mean age of 62.9 ± 11.1 years) and a 12 ± 3 months follow-up was performed. A total of 22 combined cardiovascular events(20 patients) occurred. With the use of Univariable Cox regression, all parameters were evaluated in the prediction of cardiac events, ischemic events, and/or cardiac death. According to ROC analysis, baseline mean global left atrial SRs (ROC area 0.82, p = 0.001) and baseline mean global left atrial SRe (ROC area 0.68, p = 0.036) were the only predictive variables.

Conclusions

In patients with NSTEAMI, we found that the novel global strain parameter of left atrial function is a valuable predictor of combined cardiovascular events over conventional echocardiography and may therefore be an important clinical tool for risk stratification in the acute phase of NSTEAMI.
Literature
1.
go back to reference Roger VL, Killian JM, Weston SA, Jaffe AS, Kors J, Santrach PJ, et al. Redefinition of myocardial infarction: prospective evaluation in the community. Circulation. 2006;114:790–7.CrossRefPubMed Roger VL, Killian JM, Weston SA, Jaffe AS, Kors J, Santrach PJ, et al. Redefinition of myocardial infarction: prospective evaluation in the community. Circulation. 2006;114:790–7.CrossRefPubMed
2.
go back to reference Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007;28:1598–660.CrossRefPubMed Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, et al. Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes. Eur Heart J. 2007;28:1598–660.CrossRefPubMed
3.
go back to reference Moller JE, Hillis GS, Oh JK, Seward JB, Reeder GS, Wright RS, et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003;107:2207–12.CrossRefPubMed Moller JE, Hillis GS, Oh JK, Seward JB, Reeder GS, Wright RS, et al. Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation. 2003;107:2207–12.CrossRefPubMed
4.
go back to reference Wang Z, Tan H, Zhong M, Jiang G, Zhang Y, Zhang W, et al. Strain rate imaging for noninvasive functional quantification of the left atrium in hypertensive patients with paroxysmal atrial fibrillation. Cardiology. 2008;109:15–24.CrossRefPubMed Wang Z, Tan H, Zhong M, Jiang G, Zhang Y, Zhang W, et al. Strain rate imaging for noninvasive functional quantification of the left atrium in hypertensive patients with paroxysmal atrial fibrillation. Cardiology. 2008;109:15–24.CrossRefPubMed
5.
go back to reference Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the american society of Echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the european association of echocardiography, a branch of the european society of cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.CrossRefPubMed Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification: a report from the american society of Echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the european association of echocardiography, a branch of the european society of cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.CrossRefPubMed
6.
go back to reference Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ. Global 2-dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009;54:618–24.CrossRefPubMed Cho GY, Marwick TH, Kim HS, Kim MK, Hong KS, Oh DJ. Global 2-dimensional strain as a new prognosticator in patients with heart failure. J Am Coll Cardiol. 2009;54:618–24.CrossRefPubMed
7.
go back to reference Stanton T, Leano R, Marwick TH. Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging. 2009;2:356–64.CrossRefPubMed Stanton T, Leano R, Marwick TH. Prediction of all-cause mortality from global longitudinal speckle strain: comparison with ejection fraction and wall motion scoring. Circ Cardiovasc Imaging. 2009;2:356–64.CrossRefPubMed
8.
go back to reference Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R, et al. Global and regional myocardial function quantification by two-dimensional strain: application in hypertrophic cardiomyopathy. J Am Coll Cardiol. 2006;47:1175–81.CrossRefPubMed Serri K, Reant P, Lafitte M, Berhouet M, Le Bouffos V, Roudaut R, et al. Global and regional myocardial function quantification by two-dimensional strain: application in hypertrophic cardiomyopathy. J Am Coll Cardiol. 2006;47:1175–81.CrossRefPubMed
9.
go back to reference Kim DG, Lee KJ, Lee S, Jeong SY, Lee YS, Choi YJ, et al. Feasibility of two-dimensional global longitudinal strain and strain rate imaging for the assessment of left atrial function: a study in subjects with a low probability of cardiovascular disease and normal exercise capacity. Echocardiography. 2009;26:1179–87.CrossRefPubMed Kim DG, Lee KJ, Lee S, Jeong SY, Lee YS, Choi YJ, et al. Feasibility of two-dimensional global longitudinal strain and strain rate imaging for the assessment of left atrial function: a study in subjects with a low probability of cardiovascular disease and normal exercise capacity. Echocardiography. 2009;26:1179–87.CrossRefPubMed
10.
go back to reference Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357–63.CrossRefPubMed Abhayaratna WP, Seward JB, Appleton CP, Douglas PS, Oh JK, Tajik AJ, et al. Left atrial size: physiologic determinants and clinical applications. J Am Coll Cardiol. 2006;47:2357–63.CrossRefPubMed
11.
go back to reference Chinali M, de Simone G, Roman MJ, Bella JN, Liu JE, Lee ET, et al. Left atrial systolic force and cardiovascular outcome. The Strong Heart Study. Am J Hypertens. 2005;18:1570–6. 1577.CrossRefPubMed Chinali M, de Simone G, Roman MJ, Bella JN, Liu JE, Lee ET, et al. Left atrial systolic force and cardiovascular outcome. The Strong Heart Study. Am J Hypertens. 2005;18:1570–6. 1577.CrossRefPubMed
12.
go back to reference Hashimoto I, Li X, Hejmadi BA, Jones M, Zetts AD, Sahn DJ, et al. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue doppler imaging. J Am Coll Cardiol. 2003;42:1574–83.CrossRefPubMed Hashimoto I, Li X, Hejmadi BA, Jones M, Zetts AD, Sahn DJ, et al. Myocardial strain rate is a superior method for evaluation of left ventricular subendocardial function compared with tissue doppler imaging. J Am Coll Cardiol. 2003;42:1574–83.CrossRefPubMed
13.
go back to reference D’Andrea A, Caso P, Romano S, Scarafile R, Cuomo S, Salerno G, et al. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: a two-dimensional speckle strain study. Int J Cardiol. 2009;132:354–63.CrossRefPubMed D’Andrea A, Caso P, Romano S, Scarafile R, Cuomo S, Salerno G, et al. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: a two-dimensional speckle strain study. Int J Cardiol. 2009;132:354–63.CrossRefPubMed
14.
go back to reference Inaba Y, Yuda S, Kobayashi N, Hashimoto A, Uno K, Nakata T, et al. Strain rate imaging for noninvasive functional quantification of the left atrium: comparative studies in controls and patients with atrial fibrillation. J Am Soc Echocardiogr. 2005;18:729–36.CrossRefPubMed Inaba Y, Yuda S, Kobayashi N, Hashimoto A, Uno K, Nakata T,  et al. Strain rate imaging for noninvasive functional quantification of the left atrium: comparative studies in controls and patients with atrial fibrillation. J Am Soc Echocardiogr. 2005;18:729–36.CrossRefPubMed
15.
go back to reference Greenberg NL, Firstenberg MS, Castro PL, Main M, Travaglini A, Odabashian JA, et al. Doppler-derived myocardial systolic strain rate is a strong index of left ventricular contractility. Circulation. 2002;105:99–105.CrossRefPubMed Greenberg NL, Firstenberg MS, Castro PL, Main M, Travaglini A, Odabashian JA, et al. Doppler-derived myocardial systolic strain rate is a strong index of left ventricular contractility. Circulation. 2002;105:99–105.CrossRefPubMed
16.
go back to reference Thomas JD, Popovic ZB. Assessment of left ventricular function by cardiac ultrasound. J Am Coll Cardiol. 2006;48:2012–25.CrossRefPubMed Thomas JD, Popovic ZB. Assessment of left ventricular function by cardiac ultrasound. J Am Coll Cardiol. 2006;48:2012–25.CrossRefPubMed
17.
go back to reference Park YH, Kang SJ, Song JK, Lee EY, Song JM, Kang DH, et al. Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction. J Am Soc Echocardiogr. 2008;21:262–7.CrossRefPubMed Park YH, Kang SJ, Song JK, Lee EY, Song JM, Kang DH, et al. Prognostic value of longitudinal strain after primary reperfusion therapy in patients with anterior-wall acute myocardial infarction. J Am Soc Echocardiogr. 2008;21:262–7.CrossRefPubMed
18.
go back to reference Hung CH, Shin SH, Hassanein A. Strain and strain rate imaging are independent predictors of mortality after high-risk myocardial infarction[abstract]. J Am Coll Cardiol. 2008;10:A142. Hung CH, Shin SH, Hassanein A. Strain and strain rate imaging are independent predictors of mortality after high-risk myocardial infarction[abstract]. J Am Coll Cardiol. 2008;10:A142.
19.
go back to reference Poulsen SH, Jensen SE, Moller JE, Egstrup K. Prognostic value of left ventricular diastolic function and association with heart rate variability after a first acute myocardial infarction. Heart. 2001;86:376–80.CrossRefPubMedPubMedCentral Poulsen SH, Jensen SE, Moller JE, Egstrup K. Prognostic value of left ventricular diastolic function and association with heart rate variability after a first acute myocardial infarction. Heart. 2001;86:376–80.CrossRefPubMedPubMedCentral
Metadata
Title
Independent prognostic value of left atrial function by two-dimensional speckle tracking imaging in patients with non -ST-segment-elevation acute myocardial infarction
Authors
Chunlai Shao
Jing Zhu
Jianchang Chen
Weiting Xu
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2015
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-015-0135-9

Other articles of this Issue 1/2015

BMC Cardiovascular Disorders 1/2015 Go to the issue