Quantifying Left Atrial Dysfunction in Heart Failure: A Single-Center Study Comparing Heart Failure With Preserved and Reduced Ejection Fractions via Speckle Tracking Echocardiography

Abstract

Objective:

Heart failure (HF) significantly impacts left atrial (LA) function. The aim of this study was to evaluate LA strain indices via speckle tracking echocardiography in patients with HF with reduced ejection fraction (HFrEF), HF with preserved ejection fraction (HFpEF), and a healthy control group.

Materials and Methods:

This cross-sectional study included 75 HF patients and 69 healthy controls and was conducted at major Vietnamese hospital from April 2023 to April 2024. The LA strain was measured via QLAB software, which is focused on reservoir, conduit, and contractile strains (LASr, LAScd, and LASct, respectively).

Results:

The LA strain indices were notably lower in the HFpEF and HFrEF groups than in the control group (p < .001), with no discernible differences between the HFpEF and HFrEF groups (p > .99). After adjusting for age, systolic and diastolic blood pressure, differences remained significant, showing independence from these factors. Correlation analysis revealed positive associations between LA strain indices and the LA volume index, particularly for LAScd_ED and LAScd_AC. Intraobserver and interobserver variability assessments demonstrated good reproducibility with high intraclass correlation coefficients.

Conclusion:

This cohort study provides limited evidence that significantly reduced LA strain in both HFpEF and HFrEF patients compared with healthy individuals and in this cohort, there no difference between subtypes.