The following is a summary of “Echocardiographic left atrial stiffness index predicts high left ventricular filling pressures in patients with acute heart failure: an observational study,” published in the October 2024 issue of Cardiology by Camilli et al.

Managing acute heart failure (AHF) often involves closely monitoring left ventricular filling pressures (LVFPs) to guide treatment decisions. While left atrial (LA) mechanics are believed to be key in assessing LVFPs, they haven’t been thoroughly explored in this context.

Researchers conducted a prospective study evaluating how well the echocardiographic LA stiffness index correlates with invasive LVFP measurements and to see how accurately it diagnoses LVFP compared to other commonly used clinical parameters.

They included patients with suspected acute coronary syndrome and AHF signs underwent comprehensive echocardiography, including LA reservoir strain (LARS). LA stiffness index was calculated using speckle-tracking and Tissue Doppler imaging as E/e’/LARS, alongside available invasive LVFP estimates.

The results showed that invasively measured LVFPs showed a strong correlation with the LA stiffness index (Spearman ρ = 0.773, P< 0.0001), as well as with LARS and E/e’. ROC analysis indicated the LA stiffness index outperformed average E/e’, LA volume, or LARS alone in predicting high LVFPs. In an independent group, the LA stiffness threshold of 0.48 achieved a positive predictive value of 91.7% and a negative predictive value of 88.9% for identifying high LVFPs.

Investigators concluded that this study is the first to examine the diagnostic performance of the LA stiffness index in a varied AHF population, showing its strong correlation with invasive LVFPs and its comparability to standard diastolic function measures.

Source: link.springer.com/article/10.1007/s00392-024-02562-8