Abstract 20085: 3-Dimensional Left Atrial Strain, a Novel Marker of Left Atrial Function in Patients Receiving Chemotherapy

IntroductionThere is growing support for the serial use of echocardiography to monitor cardiac function in oncology patients to prevent adverse outcomes. Upwards of 40% of patients receiving anthracyclines will develop some form of cardiotoxicty, including congestive heart failure (CHF). Recent data has suggested that left atrial (LA) function has more prognostic value than atrial volumes, especially in the setting of CHF. LA deformation analysis (strain) is a newly developed tool for assessment of LA function that has shown promise clinically. To date, no one has studied the use of LA strain as a measurement of atrial function in patients receiving cardiotoxic chemotherapeutic agents.Hypothesis3-Dimensional (3-D) LA strain can be used to monitor LA function in patients receiving cardiotoxic chemotherapeutic agentsMethodsConsecutive patients who underwent a clinically indicated echo at various times during their chemotherapy regimen were included in our analysis. Patients underwent a standard 2-D/3-D echo, with LV and LA functional and deformation analysis. Patients were excluded if they had ≥ 2 LA wall segments that were not visualized or poor wall tracking as noted by an expert echocardiographer. LA functional parameters measured included reservoir, conduit and pump strains and LA emptying fraction.ResultsWe analyzed 38 patients (26% men, mean age 59 y) currently receiving anthracyclines. 3-D LA max volumes were larger than 2D LA max volumes (62 ml vs 55 ml, p = .13). 3-D LA max volumes showed a strong positive correlation to 2-D LA max volumes (R = 0.81). 3-D LA reservoir and pump function showed positive correlations to left atrial emptying fraction while conduit strain did not (Figure 1).ConclusionsBoth 3-D left atrial reservoir strain and 3-D pump strain directly correlated with LA emptying fraction, providing a novel indicator of LA function in cardio-oncology patients.