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CLEAR FILTERS
Can we use Left Atrial Ejection Fraction (LAEF) to identify diastolic dysfunction?
Session:
Posters - B. Imaging
Speaker:
José Lopes De Almeida
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.1 Echocardiography
Session Type:
Posters
FP Number:
---
Authors:
José Lopes De Almeida; p. Paiva; n. António; m. Ferreira; r. Martins; l. Gonçalves
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Background:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">The gold standard for assessment of atrial compliance is speckle-tracking echocardiography, but new simpler alternatives have emerged, including the left atrial ejection fraction (LAEF). LAEF has been previously shown to accurately distinguish between patients with and without clearly defined left ventricle diastolic dysfunction (LVDD) by ASE/ESC criteria, but indeterminate cases were excluded. We sought to determine if LAEF could accurately distinguish between indeterminate and LVDD patients. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">A retrospective cohort of 125 patients who underwent transthoracic echocardiography was studied. Doppler peak velocities of passive (MV E) and active filling (MV A) were measured and ratio E/A calculated. Tissue Doppler imaging parameters of peak early (e′) of the septal and lateral mitral annulus were measured, and average E/e′ ratio (E/e′) was calculated. Tricuspid regurgitation velocity, left atrial maximum volume and left atrial minimum volume were measured, allowing calculation of LAEF. Subjects were assigned LVDF categories. ANOVA test was used to compare means between groups and binary logistic regression and ROC curves to access diagnostic accuracy. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">LVDD ASE/ESC category distribution was: Normal (n=22); Indeterminate (n=40); LVDD (n=63).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Mean LAEF was statistically different between groups (p<0.001): 56.3% ± 4.5 for normal patients, 50.2% ± 5.5 for indeterminate patients and 44% ± 8.5 for patients with LVDD (Figure). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Binomial logistic regression model determined that LAEF distinguished LVDD from indeterminate patients (OR = 1.1, 95%CI 1.05-1.21, p<0.001).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">ROC shows that LAEF has good diagnostic accuracy to identify LVDD among indeterminate patients (AUC 0.72, 95%CI 0.62-0.82) and excellent diagnostic accuracy to identify LVDD among normal patients (AUC 0.91, 95%CI 0.84-0.97).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusions:</strong></span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">LAEF is a strong predictor of LVDD and does not lose its discriminatory power among indeterminate patients. </span></span></p>
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