title: Assessment of Inter and Intra-atrial Asynchrony in Patients with Systolic Heart Failure Using Velocity Vector Imaging.
abstract: BACKGROUND
  According to previous studies on the deformation properties of the left atrium, the systolic strain and strain rates represent the atrial reservoir function and the early and late diastolic strain rates show the conduit and booster functions, respectively.
  
  
  OBJECTIVE
  We sought to evaluate the intra and interatrial asynchrony using strain/strain rate imaging in systolic heart failure patients.
  
  
  METHODS
  Twenty five patients with systolic heart failure (LVEF ≤ 40%) were enrolled into the study. Asynchrony quantifications were performed according to the standard deviation of time-to peak (TP-SD) of deformation of three segments manually located along the perimeter of the left atrium free wall, right atrium free wall and interatrial septum, as imaged in an apical four-chamber view. We also calculated classic echocardiography parameters such as LV end-diastolic dimension index, LA volume index, RA area, as well as deceleration time (DT) on transmitral pulsed wave Doppler and E/E' ratio on mitral annular tissue Doppler imaging.
  
  
  RESULTS
  In heart failure patients either inter or intra-atrial asynchrony were far more common in comparison with normal subjects (P=0.008 and P=0.007 respectively).
  
  
  CONCLUSIONS
  Left ventricular systolic heart failure, may result in inter and intra-atrial asynchrony even in clinically stable patients without significant pulmonary hypertension and diastolic dysfunction.
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Esmaeilzadeh
authors.affiliation: Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IR Iran.
authors.forename: Marzieh
authors.initials: M
authors.lastname: Nikparvar
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Maleki
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Feridoun
authors.initials: F
authors.lastname: Noohi
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Ojaghi Haghighi
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Niloufar
authors.initials: N
authors.lastname: Samiei
authors.affiliation: Echocardiography Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Paridokht
authors.initials: P
authors.lastname: Nakhostin-Davari
authors.affiliation: Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hooman
authors.initials: H
authors.lastname: Bakhshandeh
keywords: Asynchrony; Heart Failure; Strain