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Left atrial contraction strain during a Valsalva manoeuvre: A study in healthy humans
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.ORCID iD: 0000-0002-4606-9308
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Clinical Physiology.ORCID iD: 0000-0002-8129-8771
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Anaesthesiology.ORCID iD: 0000-0002-8802-2321
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2023 (English)In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 43, no 3, p. 165-169Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Cardiac mechanics are influenced by loading conditions as well as sympathetic tone. Left atrial (LA) contractile function assessed by two-dimensional (2D) strain has been described in the setting of controlled preload alterations; however, studies show conflicting findings about change or direction of change. We hypothesized that the controlled preload reduction and the sympathetic nervous system activation that occurs during a standardized Valsalva manoeuvre would bring about a change in LA contraction strain.a

METHODS: Healthy young adults of both sexes were recruited. Transthoracic echocardiographic ultrasound images were collected before and during a Valsalva manoeuvre. Standard imaging windows for LA strain assessment were used and the images were copied and stored for later offline analysis. These were assessed for adequate atrial wall visualization in 2D strain assessment. Paired comparisons were carried out using Student's T test.

RESULT: Thirty-eight participants were included and there were 22 complete studies with paired pre- and during Valsalva manoeuvre. LA contraction strain at baseline was 10.5 ± 2.8% (standard deviation) and during the Valsalva manoeuvre 10.6 ± 4.6%, p = 0.86.

CONCLUSION: The Valsalva manoeuvre, a combination of preload reduction and sympathetic nervous system activation, seems not to be associated with a change in LA contraction strain in healthy young individuals. LA contraction strain should be interpreted in the context of both atrial loading conditions and prevailing autonomic nervous system activity.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 43, no 3, p. 165-169
Keywords [en]
contractile function, echocardiography, left atrium, preload, speckle tracking, sympathetic nervous system
National Category
Anesthesiology and Intensive Care Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-202113DOI: 10.1111/cpf.12806ISI: 000902530500001PubMedID: 36533722Scopus ID: 2-s2.0-85145300941OAI: oai:DiVA.org:umu-202113DiVA, id: diva2:1723119
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Region VästerbottenAvailable from: 2023-01-02 Created: 2023-01-02 Last updated: 2023-09-05Bibliographically approved

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Gottfridsson, PeterLaw, LucyAroch, RomanMyrberg, TomiHultin, MagnusLindqvist, PerHaney, Michael

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