title: Relation of left atrial peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in patients presenting with ST-elevation myocardial infarction.
abstract: BACKGROUND
  In patients presenting with ST-elevation myocardial infarction (STEMI), we investigated the relation of left atrial (LA) deformational parameters evaluated by two-dimensional speckle tracking imaging (2D-STI) with conventional echocardiographic diastolic dysfunction parameters and B-type natriuretic peptide (BNP) level.
  
  
  METHODS
  Ninety STEMI patients who were treated with primary percutaneous coronary intervention (PCI) and 22 healthy control subjects were enrolled. STEMI patients had echocardiographic examination 48 hours after the PCI procedure and venous blood samples were drawn simultaneously. In addition to conventional echocardiographic parameters, LA strain curves were obtained for each patient. Average peak LA strain values during left ventricular (LV) systole (LAs-strain) were measured.
  
  
  RESULTS
  BNP values were higher in MI patients compared to controls. Mean LAs-strain in control group was higher than MI group (30.6 ± 5.6% vs. 21.6 ± 6.6%; p = 0.001). LAs-strain had significant correlation with LVEF (r = 0.51, p = 0.001), also significant inverse correlations between LAs-strain and BNP level (r = -0.41, p = 0.001), E/Em (r = -0.30, p = 0.001), LA maximal volume (r = -0.41, p = 0.001), LA minimal volume (r = -0.50, p = 0.001) and LV end systolic volume (r = -0.37, p = 0.001) were detected. The cut off value of LAs-strain to predict BNP > 100 pg/ml was determined as 19.9% with 55.3% sensitivity and 77.2% specificity (p < 0.05 AUC:0.7).
  
  
  CONCLUSIONS
  Our study showed that LAs-strain values decreased consistently with deteriorating systolic and diastolic function in STEMI patients treated with primary PCI. LA-s strain measurements may be helpful as a complimentary method to evaluate diastolic function in this patient population.
authors.forename: Cem
authors.initials: C
authors.lastname: Dogan
authors.forename: Nihal
authors.initials: N
authors.lastname: Ozdemir
authors.forename: Suzan
authors.initials: S
authors.lastname: Hatipoglu
authors.forename: Ruken Bengi
authors.initials: RB
authors.lastname: Bakal
authors.forename: Mehmet Onur
authors.initials: MO
authors.lastname: Omaygenc
authors.forename: Baris
authors.initials: B
authors.lastname: Dindar
authors.forename: Ozkan
authors.initials: O
authors.lastname: Candan
authors.forename: Mehmet Yunus
authors.initials: MY
authors.lastname: Emiroglu
authors.forename: Cihangir
authors.initials: C
authors.lastname: Kaymaz
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D016279:Atrial Function, Left / Q000502:physiology; D016022:Case-Control Studies; D003971:Diastole / Q000502:physiology; D015150:Echocardiography, Doppler / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D015588:Observer Variation; D012372:ROC Curve; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
chemical_list: D020097:Natriuretic Peptide, Brain