Valeur pronostique du strain atrial dans la cardiomyopathie dilatée non ischémique

Introduction: Left atrial function in non-ischemic dilated cardiomyopathy (DCM) has long been underestimated when studying the ultrasound parameters of DCM. Currently, several ultrasound parameters of left atrial function have been proposed as markers to detect patients at risk. Aim : To evaluate the left atriumfunctionwith 2D speckle tracking echocardiography and itsprognostic value in the dilatedcardiomyopathy. Methods : The study prospectively recruited 40 patients with dilated cardiomyopathy, between January and June 2014, followed up at the cardiology department of Habib Thameur Hospital of Tunis. An echocardiogram was performed for all patients at the beginning of the study. After a 6-month follow-up, the primary endpoint was the occurrence of a major cardiovascular event. The patients were divided into a first group without cardiovascular events (group 1) and a second group with a cardiovascular event (group 2). Results : During the follow-up, 25 patients presented a major cardiovascular event (8 ventricular arrhythmias and 17 hospitalizations for acute decompensated heart failure). There were no significant differences between the two groups regarding cardiovascular risk factors, symptoms and blood testing values.In addition, regarding results obtained from speckle tracking echocardiography, atrial peak-systolic longitudinal strain (PALS) and time to peak atrial longitudinal strain (TPALS) values were observed to be significantly lower in group 2 ( 34.6% in group 1 vs 28.4% in group 2, p=0.000; and 344.6ms in group 1 vs 349.8 ms in group 2, p=0.016 respectively). Conclusion : The analysis of the LA speckle tracking in the dilatedcardiomyopathymay help cardiologistto identify patients at high cardiovascular risk and thus improve their management and follow-up.