@article{10.37349/ec.2024.00018,
abstract = {Aim: Left atrial volume index (LAVI), left atrial reservoir function through left atrial reservoir strain (LASr), and B-lines in lung ultrasound serve as supplementary indicators of left ventricular filling pressures. This study analyzes the interrelation between LAVI, LASr, and B-lines in both resting and peak vasodilator stress. Methods: Dipyridamole stress echocardiography (SE) was conducted on 252 individuals (180 males, 71%, age 65 years ± 10 years) with chronic coronary syndromes. LAVI was quantified using the biplane disk summation method; LASr was obtained using 2-dimensional speckle tracking echocardiography; B-lines were evaluated through a simplified 4-site scan in the third intercostal space during lung ultrasound. Results: During SE, a reduction in LAVI (26 ml/m2 ± 14 ml/m2 vs. 24 ml/m2 ± 12 ml/m2, P < 0.001) and an increase in LASr from rest (33% ± 8% vs. 38% ± 10%, P < 0.001) were respectively observed from rest to stress. B-lines were increased significantly during SE, from 19 (7.5%) to 29 (11.5%), P < 0.001. A substantial, inverse linear correlation was identified between LAVI and LASr both at rest (r = –0.301, P < 0.001) and peak stress (r = –0.279, P < 0.001). At group analysis, peak B-lines showed a direct correlation with peak LAVI (r = 0.151, P = 0.017) and an inverse correlation with peak LASr (r = –0.234, P < 0.001). In individual assessments, 9.7% (20/207) of patients displayed stress B-lines with normal LAVI and preserved LASr, while 20% (9/45) exhibited stress B-lines with abnormalities in both LAVI and LASr. Conclusions: Vasodilator SE with combined left atrial and volume assessment, related to pulmonary congestion, is feasible with a high success rate. Pulmonary congestion is more frequent with dilated left atrium with reduced atrial contractile reserve (ClinicalTrials.gov identifier: NCT030.49995; NCT050.81115).},
author = {Prota, Costantina and Cortigiani, Lauro and Campagnano, Ettore and Wierzbowska-Drabik, Karina and Kasprzak, Jaroslaw and Colonna, Paolo and Merli, Elisa and Manganelli, Fiore and Gaibazzi, Nicola and D'Andrea, Antonello and Cerracchio, Emma and Meola, Laura and Citro, Rodolfo and Villari, Bruno and Ciampi, Quirino},
doi = {10.37349/ec.2024.00018},
journal = {Exploration of Cardiology},
pages = {19--30},
title = {{Left atrium stress echocardiography: correlation between left atrial volume, function, and B-lines at rest and during stress}},
url = {https://www.explorationpub.com/Journals/ec/Article/101218},
volume = {2},
year = {2024},
number = {1}
}