Left ventricular strain rate for intraoperative evaluation of cardiac diastolic function by transesophageal echocardiography: the correlation between late diastolic peak longitudinal strain rate and the severity of diastolic dysfunction
Ebrahimi F, Gharedaghi MH, Shafaroodi H, Ghasemi M, Aghajani K, Candido K. Left Ventricular Strain Rate for Intraoperative Evaluation of Cardiac Diastolic Function by Transesophageal Echocardiography: The Correlation Between Late Diastolic Peak Longitudinal Strain Rate and the Severity of Diastolic Dysfunction. J Cardiothorac Vasc Anesth. 2022;36(1):178-183. doi:10.1053/j.jvca.2021.06.033
Objectives: Speckle-tracking echocardiography is a promising tool for evaluating cardiac diastolic dysfunction. A correlation between left atrial strain rate during atrial contraction and the severity of diastolic dysfunction previously has been demonstrated. Because visualization of the left atrial walls is difficult with transesophageal echocardiography, the authors evaluated the use of left ventricular strain rate during atrial contraction as a substitute for left atrial strain rate to intraoperatively measure the extent of cardiac diastolic dysfunction.
Design: Retrospective clinical study.
Setting: Single institutional study.
Participants: Sixty-six patients who underwent cardiac surgery between January 2018 and January 2021.
Measurements and main results: Preoperative echocardiographic reports and intraoperative echocardiographic images of the participants were studied. The correlation of cardiac diastolic dysfunction stage with the peak longitudinal strain rate during late diastole and the time to peak value were evaluated. The late diastolic peak longitudinal strain rate was correlated significantly with the stage of diastolic dysfunction (r = -0.64, p < 0.0001). There was no significant correlation between the stage of diastolic dysfunction and the time to peak value (r = -0.17, p = 0.18). A late diastolic peak longitudinal strain rate <0.68 1/s had a sensitivity of 80% and specificity of 81% for predicting grade 2 or 3 diastolic dysfunction.
Conclusions: The late diastolic peak longitudinal strain rate correlates with the severity of diastolic dysfunction in patients undergoing cardiac surgery.