Abstract 16 Determinants of left atrial reservoir strain in healthy women with normal or mildly impaired diastolic function: results from the prospective BErlin Female Risk Evaluation (BEFRI) follow up trial

Objectives: Analyze the clinical and echocardiographic parameters associated with left atrial (LA) strain and its deterioration in women with impaired diastolic function.

Background: LA function, measured by phasic two-dimensional strain, has shown its importance in diagnosing diastolic dysfunction, particularly in early stages, and in grading its severity. For application in clinical practice, it is important to understand which factors determine the magnitude of the LA strain components.

Methods: We performed a comprehensive echocardiographic follow up examination, including LA phasic strain, in 256 healthy women from the 449 participants of the BErlin Female Risk Evaluation (BEFRI) study, who were reinvited after a mean time interval of 6.8 years. We assessed determinants of LA reservoir strain (LASr) worsening and other parameters impacting on the development of diastolic dysfunction over time, and compared it with standard echocardiographic parameters using receiver operating characteristic curve (ROC) analyses and a multivariate logistic regression model. To assess which variables were independent determinants of LASr, we performed univariate linear regression analyses, followed by a multivariate linear regression analysis.

Results: Two participants were excluded due to insufficient imaging quality for analyzing LASr, so that we examined LA function parameters of 254 women after a mean follow up of 6.8 year. 52 of them (20,5%) presented a deterioration of LASr below the cut-off value of 34%, which was the highest discriminative value to predict the impairment of diastolic dysfunction in the follow up with an area under the curve (AUC) of 0.88 [95% confidence interval (CI) 0.83-0.94], and 0.85 (95% CI 0.80-0.90). In a multivariate linear regression model, age, Body Mass index (BMI) and deterioration of diastolic function (DD_progress) remained significantly associated with LASr over time after controlling for LA volume index (LAVI), E/e’ and other standard echocardiographic parameters (Table).

Conclusion: The strongest determinant of LASr in a healthy population of women is impairment of diastolic function, followed by age and body mass index. LA volume index showed weak correlations with LASr and with the deterioration of diastolic function.

Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5
Determinants of left atrial reservoir strain in healthy women with normal or mildly impaired diastolic function: results from the prospective BErlin Female Risk Evaluation (BEFRI) follow up trial
E. Romero Dorta¹, D. Blaschke-Waluga², A. Wolf¹, K. Stangl³, U. Seeland⁴, F. Knebel³, V. Stangl³, A. M. Brand³, für die Studiengruppe: BEFRI
¹Charité - Universitätsmedizin Berlin, Berlin; ²Kardiologie Potsdam, Potsdam; ³CC11: Med. Klinik m. S. Kardiologie und Angiologie, Charité - Universitätsmedizin Berlin, Berlin; ⁴Institut für Physiologie - AG Bioinformatik, Charité - Universitätsmedizin Berlin, Berlin;
Objectives: Analyze the clinical and echocardiographic parameters associated with left atrial (LA) strain and its deterioration in women with impaired diastolic function. Background: LA function, measured by phasic two-dimensional strain, has shown its importance in diagnosing diastolic dysfunction, particularly in early stages, and in grading its severity. For application in clinical practice, it is important to understand which factors determine the magnitude of the LA strain components. Methods: We performed a comprehensive echocardiographic follow up examination, including LA phasic strain, in 256 healthy women from the 449 participants of the BErlin Female Risk Evaluation (BEFRI) study, who were reinvited after a mean time interval of 6.8 years. We assessed determinants of LA reservoir strain (LASr) worsening and other parameters impacting on the development of diastolic dysfunction over time, and compared it with standard echocardiographic parameters using receiver operating characteristic curve (ROC) analyses and a multivariate logistic regression model. To assess which variables were independent determinants of LASr, we performed univariate linear regression analyses, followed by a multivariate linear regression analysis. Results: Two participants were excluded due to insufficient imaging quality for analyzing LASr, so that we examined LA function parameters of 254 women after a mean follow up of 6.8 year. 52 of them (20,5%) presented a deterioration of LASr below the cut-off value of 34%, which was the highest discriminative value to predict the impairment of diastolic dysfunction in the follow up with an area under the curve (AUC) of 0.88 [95% confidence interval (CI) 0.83-0.94], and 0.85 (95% CI 0.80-0.90). In a multivariate linear regression model, age, Body Mass index (BMI) and deterioration of diastolic function (DD_progress) remained significantly associated with LASr over time after controlling for LA volume index (LAVI), E/e’ and other standard echocardiographic parameters (Table). Conclusion: The strongest determinant of LASr in a healthy population of women is impairment of diastolic function, followed by age and body mass index. LA volume index showed weak correlations with LASr and with the deterioration of diastolic function.
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