Evaluation Of Change In Left Atrial Longitudinal Strain And Strain Rate In Cardiac Amyloidosis Patients With 2D Speckle Tracking Imaging

Objective:To assess changes of left atrial longitudinal strain and strain rate in cardiac amyloidosis?CA?patients with two-dimentional speckle tracking image?2D-STI?.Methods:26 CA patients were selected as CA group and 30 healthy volunteers as the control group.The CA group was further divided into two subgroups:the severely enlarged group?left atrial volume index?LAVI??48ml/m²,11?and the not severely enlarged group?LAVI<48ml/m²,15?.Both of the groups underwent two-dimensional echocardiography,tissue Doppler imaging and 2D-STI echocardiography.The convetional 2D echovardiographic measurements included:left atrial diameter at end-systole?LADs?,peak E at early diastole?E?,peak A at late diastole?A?,e??s??a?at intraventricular septum and ratios of E/A and E/e?.Left atrial ejection fraction?LAEF?and fractional area change?FAC?were automatically obtained by analysis software,as well as lef atrial strain-derived parameters which included left atrial peak longitudinal strain(LS_peak),left atrial strain rate at early diastole(LSR_early)and left atrial strain rate at late diastole(LSR_late).Regular echocardiographic parameters,left atrial structural parameters and left atrial strain and strain rate were compared among the three groups.All the patients were followed-up every 3 months until death or the end of 24 months.Results:There were differences of E?A?e??s??a??E/A?E/e?among CA groups and control group?P<0.05?.However,there were no differences between the severely and not severely enlarged group?P>0.05?.LAEF and FAC were reduced in LAVI<48mL/m² group compared to the control group?P<0.05?.The LS_peak,LSR_peak,LSR_early and LSR_late were decreased in LAVI<48ml/m² group compared with the control group as well as the LAVI?48ml/m² group respectively?P<0.05?.The average follow-up was?11.62±10.37?months.The parameter of LS_peak was regarded as the independent risk factor according to Cox proportional-hazards model.It was supposed that there were higher possibility of malignant cardiovascular events with the value of LS_peak<0.182.Conclusion:In CA patients,left atrial deformation were severely impaired,which manifests as great reduction in peak longitudinal stain and strain rate at different diastolic phases.It also reflected early impairment in cardiac diastolic dysfunction and was correlated with clinical prognosis.The strain-derived parameters could be used to evaluate early changes in diastolic function sensitively.It also contributed to early diagnosis and evaluation of cardiac function impairment,which played a crucial role in prognosis and treatment in CA patients.