title: Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in end-stage renal disease patients with preserved left ventricular ejection fraction.
abstract: In end-stage renal disease patients with preserved LV ejection fraction undergoing chronic hemodialysis, we investigated the relationship of left atrial deformational parameters evaluated by two-dimensional speckle tracking imaging (2D-STI) with conventional echocardiographic diastolic dysfunction parameters and brain natriuretic peptide level.
  
  
  
  The study group enrolled 30 patients treated with chronic hemodialysis three times weekly. Two-dimensional transthoracic echocardiography and Doppler studies were performed 44.93 (13.46) immediately before and after HD. All patients had preserved left ventricular ejection fraction.
  
  
  
  The mean age of patients was 44.93 ± 13.46 years. The mean brain natriuretic peptide (BNP) value after HD was 221.56 ± 197.79 pg/ml. BNP values were significantly higher before HD (p = 0.004), the anteroposterior diameter, area, and the volumes of the LA decreased significantly after HD. On the other hand, the left atrial ejection fraction (LAEF) and the peak LA strain during LV systole (LAGS) were found to be higher. Before HD, there were significant inverse correlations between LAGS and BNP levels (r = -0.482, p = 0.007), E/E' (r = -0.33, p = 0.049), LAVmax (r = -0.366, p = 0.047), and LAVmin (r = -0.579, p = 0.001). LAGS had a significant correlation with E' velocity (r = 0.557, p = 0.001) (Table 5) and LAEF (r = 0.58, p = 0.001). After HD, there were also significant correlations between LAGS and echocardiographic parameters of systolic and diastolic LV function.
  
  
  
  We observed that left atrium global peak systolic strain values decreased consistently with deteriorating systolic and diastolic function. Our results suggest that LAGS measurements may be helpful as a complimentary method to evaluate diastolic function.
authors: Cardiology Department, Hedi Chaker Hospital, Route Elain, Km 0.5, 3029, Sfax, Tunisia. leilaabidt@yahoo.fr.
authors: Leila
authors: L
authors: Abid
authors: Cardiology Department, Hedi Chaker Hospital, Route Elain, Km 0.5, 3029, Sfax, Tunisia.
authors: Salma
authors: S
authors: Charfeddine
authors: Cardiology Department, Hedi Chaker Hospital, Route Elain, Km 0.5, 3029, Sfax, Tunisia.
authors: Samir
authors: S
authors: Kammoun
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation; D004452:Echocardiography; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left
chemical_list: D020097:Natriuretic Peptide, Brain
keywords: Brain natriuretic peptide; End-stage renal disease; Global peak systolic strain; Left atrium function; Left ventricular diastolic function; Preserved left ventricular ejection fraction; Strain