Clinical Physiology of Circulation

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


Parameters of deformation of the left atrium as a marker of diastolic dysfunction in patients with ischemic heart disease

Authors: Koksheneva I.V., Kaplenko L.I., Turakhonov T.K., Iraskhanov A.Sh.

Company:
Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

E-mail: Сведения доступны для зарегистрированных пользователей.

DOI: https://doi.org/10.24022/1814-6910-2022-19-4-326-337

UDC: 616.127-005.8:616.12-005.4

Link: Clinical Physiology of Blood Circulaiton. 2022; 4 (19): 326-337

Quote as: Koksheneva I.V., Kaplenko L.I., Turakhonov T.K., Iraskhanov A.Sh. Parameters of deformation of the left atrium as a marker of diastolic dysfunction in patients with ischemic heart disease. Clinical Physiology of Circulation. 2022; 19 (4): 326–37 (in Russ.). DOI: 10.24022/1814-6910-2022-19-4-326-337

Received / Accepted:  12.11.2022 / 09.12.2022

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Abstract

The aim of the study was to evaluate the relationship between the severity of LV diastolic dysfunction and LA function according to the analysis of Strain parameters and Strain Rate of the myocardium in patients with IHD.

Material and methods. The study included 80 patients with stable coronary heart disease, with preserved or moderately reduced LV contractility (LV EF ≥ 45%). Three groups were formed: group 1 (16 patients) – patients with coronary artery disease with normal LV diastolic function; group 2 (49 patients) – patients with coronary artery disease with I degree of LV DD (impaired relaxation); group 3 (15 patients) – patients with coronary artery disease with II degree of LV DD (pseudonormal filling). There were no patients with grade III LV DD (restrictive filling) in the study. All patients underwent a study of longitudinal global Strain and Strain Rate of the LA myocardium (in the reservoir, conduit, and contraction phases) and LV.

Results. It has been established that as the diastolic dysfunction worsens, there is a decrease in the Strain and Strain Rate parameters of the LA during all phases of its mechanical function – reservoir, conduit and active contraction. The stiffness of the left atrial myocardium also increases as LV diastolic dysfunction worsens. At the same time, the parameters of structural remodeling of the LA (linear dimensions and indexed volume of the LA) did not differ significantly in patients with varying degrees of LV DD. Correlation relationships of Strain and Strain Rate of LA in the reservoir phase (LASr) with indicators of LV diastolic function (e', E/e') and in the contraction phase (LASct) with рulmonary capillary wedge pressure were established.

Conclusion. LA Strain is a marker of LA dysfunction that occurs with the progression of DD. The study of LA Strain can be a useful additional tool for assessing diastolic dysfunction in clinical practice.

About Authors

  • Inna V. Koksheneva, Dr. Med. Sci., Senior Researcher; ORCID
  • Lidiya I. Kaplenko, Postgraduate; ORCID
  • Timur K. Turakhonov, Cand. Med. Sci., Cardiologist; ORCID
  • Atabi Sh. Iraskhanov, Applicant; ORCID

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