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Left atrial ejection fraction is an indicator of left ventricular diastolic function

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Abstract

Left atrial ejection fraction (LAEF) has been previously shown to accurately distinguish between patients with and without clearly defined left ventricle diastolic dysfunction (LVDD) by ASE/EACVI criteria, but indeterminate cases were excluded. We sought to determine if LAEF could accurately distinguish between normal, indeterminate and LVDD patients. A retrospective cohort of 125 patients who underwent transthoracic echocardiography was studied. Comprehensive echocardiographic study was performed with measurement of validated diastolic parameters. Subjects were assigned LVDF ASE/EACVI categories. ANOVA test was used to compare means between groups and binary logistic regression and ROC curves to assess diagnostic accuracy. 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. LAEF distinguished LVDD from patients without diastolic dysfunction (OR = 0.73, 95% CI 0.63–0.65, p < 0.001) and ROC curve reveals excellent discriminative power (AUC 0.91, 95% CI 0.84–0.97, p < 0.001). LAEF also distinguished indeterminate patients from LVDD (OR = 0.9, 95% CI 0.83–0.95, p < 0.001) and ROC curve revealed good discriminative power (AUC 0.72, 95% CI 0.62–0.82, p < 0.001). LAEF can accurately differentiate between normal, indeterminate and LVDD patients and could be considered as an additional parameter in the study of diastolic function.

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Abbreviations

A2C:

Apical two chamber

A4C:

Apical four chamber

AF:

Atrial fibrillation

ASE:

American Society of Echocardiography

CMR:

Cardiac magnetic resonance

EACVI:

European Association of Cardiovascular Imaging

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

LAEF:

Left atrial ejection fraction

LAmax:

Left atrial maximum volume

LAmin:

Left atrial minimum volume

LAVI:

Left atrial volume index

LVDD:

Left ventricle diastolic dysfunction

LVEF:

Left ventricle ejection fraction

TDI:

Tissue Doppler Imaging

TR:

Tricuspid regurgitation

TTE:

Transthoracic echocardiogram

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Author notes

  1. J. Almeida and P. Paiva are Co-first authors.

Authors and Affiliations

  1. Cardiology Service, Coimbra Hospital and University Center, Praceta, R. Prof. Mota Pinto, 3004-561, Coimbra, Portugal

    J. Almeida, N. Ribeiro, M. Ferreira, N. António, R. Martins & L. Gonçalves

  2. Clinical Pharmacology Unit, Coimbra Hospital and University Center, Coimbra, Portugal

    P. Paiva

  3. Institute of Pharmacology and Experimental Therapeutics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    P. Paiva & N. António

  4. Clinical Academic Center of Coimbra, Coimbra Hospital and University Center and Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    P. Paiva

  5. University Clinic of Cardiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal

    M. Ferreira, N. António & L. Gonçalves

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  1. J. Almeida
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Correspondence to J. Almeida.

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Almeida, J., Paiva, P., Ribeiro, N. et al. Left atrial ejection fraction is an indicator of left ventricular diastolic function. Int J Cardiovasc Imaging 38, 33–39 (2022). https://doi.org/10.1007/s10554-021-02357-2

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  • DOI: https://doi.org/10.1007/s10554-021-02357-2

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