A cross-sectional study to determine the association of left atrial strain with NT-proBNP and 6minute walk test using 2D strain imaging in patients with diastolic dysfunction
R A H U L Choudhary, N Bordiya, S Deora, A KaushikAbstract
Background
Heart failure with preserved ejection fraction (HFpEF) is caused by diastolic dysfunction (DD) and accelerates with age and cardiovascular risk factors. DD impairs physical capacity, decreasing exercise tolerance and quality of life, measured by the 6-minute walk test (6MWT). Heart failure (HF) is characterized by elevated diastolic filling pressure, which activates natriuretic peptide secretion, such as NT-proBNP. The current research seeks to assess the relationship between LA strain, NT-proBNP and 6MWT with respect to present standard guidelines in patients with DD.
Objective
To determine the association of Left atrial strain with NT-proBNP and 6-Minute Walk Test using 2D strain imaging.
Material and Methods
A hospital-based cross-sectional study at AIIMS Jodhpur (Feb 2023-Aug 2024) enrolled consenting patients aged ≥18 years with risk factors for LV diastolic dysfunction. 82 eligible subjects underwent assessment with history, examination, ECG, laboratory investigations (including NT-proBNP), echocardiography, and 6MWT. LA strain was measured using 2D speckle tracking, and statistical analysis employed SPSS 25.0 software, ANOVA and Kruskal Wallis Tests, Pearson and Spearman's rho Correlation coefficients.
Results
The population under study was 82 patients with risk factors for DD (63 males, 19 females, mean age 51.94 years). 91.5% were hypertensive, 26.8% diabetic, and mean peak LA strain was 27.92%. 6MWT distance reduced with worsening DD, whereas NT-Pro BNP levels rose. Peak LA strain correlated positively with 6MWT and inversely with NT-Pro BNP.
Conclusion
NT-proBNP levels differ considerably with DD grades, and peak LA strain correlated negatively significantly with NT-proBNP (Spearman's rho Correlation coefficient: 0.677, p <0.001). The 6MWT reduces as the DD grade severity increases, with greater statistical significance. Peak LA strain correlated positively significantly with 6MWT (Pearson Correlation coefficient: 0.657, p <0.001).Peak LA strain and 6MWTFor image description, please refer to the figure legend and surrounding text.Peak LA strain and NT Pro-BNP levelsFor image description, please refer to the figure legend and surrounding text.