Transthoracic echocardiography was performed with the patients at rest on an EPIQ 7C ultrasound system (Philips Healthcare, Amsterdam, the Netherlands) according to the guidelines of the American Society of Echocardiography (2019) [12 (link)].
Additional optimized left ventricular (LV) and LA images were acquired at a frame rate > 50 frames/s. In apical 4-, 3-, and 2-chamber views of 3 continuous cardiac cycles at rest, the early diastolic peak flow velocity of the mitral valve on pulsed-wave Doppler (E), the early diastolic velocity of the septal and lateral wall annulus on tissue Doppler (e′) and the ratio of E to e′ (E/e′) were calculated. Three-dimensional full-volume images at rest were acquired to calculate the LV volume, stroke volume and ejection fraction. All images were stored digitally. The volume and strain analyses were performed offline using commercially available software (QLab 10.8.0; Philips Healthcare). The LA maximum and minimum volume index (LAVImax and LAVImin, respectively) and the LA total empty fraction (LATEF) were evaluated from the apical 4- and 2-chamber views by the 2-dimensional quantitative speckle-tracking method [13 (link)].
Additional optimized left ventricular (LV) and LA images were acquired at a frame rate > 50 frames/s. In apical 4-, 3-, and 2-chamber views of 3 continuous cardiac cycles at rest, the early diastolic peak flow velocity of the mitral valve on pulsed-wave Doppler (E), the early diastolic velocity of the septal and lateral wall annulus on tissue Doppler (e′) and the ratio of E to e′ (E/e′) were calculated. Three-dimensional full-volume images at rest were acquired to calculate the LV volume, stroke volume and ejection fraction. All images were stored digitally. The volume and strain analyses were performed offline using commercially available software (QLab 10.8.0; Philips Healthcare). The LA maximum and minimum volume index (LAVImax and LAVImin, respectively) and the LA total empty fraction (LATEF) were evaluated from the apical 4- and 2-chamber views by the 2-dimensional quantitative speckle-tracking method [13 (link)].
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