Aims: To evaluate the relationship between left atrial (LA) structure and deformation obtained by two-dimensional speckle tracking echocardiography (2DSTE): peak longitudinal systolic strain (LAs), peak longitudinal systolic strain rate (LAS-SR), peak longitudinal early diastolic strain rate (LAE-SR), peak longitudinal late diastolic strain rate (LAA-SR), and sleep-disordered breathing (SDB) estimated by means of apnea-hypopnea index (eAHI).
Methods: Thirty-two individuals with ischemic heart disease (IHD) and impaired left ventricular ejection fraction (EF < 50%) were included in the study. LA function was assessed using 2DSTE. eAHI index was calculated by means of the 24-hour ambulatory Holter electrocardiogram monitoring. Patients were categorized into two subgroups: SDB group (eAHI ≥ 15; n = 15) and non-SDB group (eAHI < 15; n = 17).
Results: All 2DSTE parameters were decreased in the SDB group: LAS-SR (0.90 [0.60-1.25] 1/sec vs. 1.25 [1.00-1.27] 1/sec, P = 0.043), LAE-SR (-0.76 ± 0.49 1/sec vs. -1.18 ± 0.55 1/sec, P = 0.033), and LAA-SR (-1.26 ± 0.71 1/sec vs. -1.48 ± 0.75 1/sec, P = 0.049). The eAHI was negatively correlated with LA reservoir function: LAS (r = -0.53, P = 0.002) and LAS-SR (r = -0.47, P = 0.006), while it is positively correlated with LAE-SR (r = 0.67, P < 0.001) and LAA-SR (r = 0.46, P = 0.009). Moreover, SDB severity was an independent predictor of impaired LA compliance (P = 0.016) and conduit function (P = 0.002) in multivariate linear regression model, even after adjustment for age, BMI, gender, LV systolic (EF), and diastolic (E/e') function and comorbidities.
Conclusions: LA dysfunction and remodeling assessed using 2DSTE in patients with impaired systolic LV function, and IHD is influenced by the severity of sleep apnea independently from LV function.
Keywords: diastolic function; ischemic heart disease; left atrium; strain; strain rate imaging; systolic function.
© 2015, Wiley Periodicals, Inc.