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Left atrial structu...
Left atrial structural and mechanical remodelling in heart failure with reduced ejection fraction
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- Rossi, Andrea (author)
- Division of Cardiology, Azienda Ospedaliero Universitaria Verona, Verona, Italy
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- Carluccio, Erberto (author)
- Cardiologia e Fisiopatologia Cardiovascolare, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Perugia, Italy
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- Cameli, Matteo (author)
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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- Inciardi, Riccardo M. (author)
- Cardiology, ASST Spedali Civili di Brescia and Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
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- Mandoli, Elena G. (author)
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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- D'Agostino, Andreina (author)
- Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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- Biagioli, Paolo (author)
- Cardiologia e Fisiopatologia Cardiovascolare, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Perugia, Italy
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- Maffeis, Caterina (author)
- Division of Cardiology, Azienda Ospedaliero Universitaria Verona, Verona, Italy
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- Pugliese, Riccardo N. (author)
- Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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- Pastore, Concetta M. (author)
- Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy
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- Mengoni, Anna (author)
- Cardiologia e Fisiopatologia Cardiovascolare, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Perugia, Italy
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- Pedrinelli, Roberto (author)
- Departmento di Patologia Chirurgica, Medica, Molecolare e dell' Area Critica University of Pisa, Pisa, Italy
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- Henein, Michael (author)
- Umeå universitet,Avdelningen för medicin
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- Dini, Frank L. (author)
- Cardiac, Thoracic and Vascular Department, University of Pisa, Pisa, Italy
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(creator_code:org_t)
- 2021-11-02
- 2021
- English.
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In: ESC Heart Failure. - : John Wiley & Sons. - 2055-5822. ; 8:6, s. 4751-4759
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Abstract
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- Aims: In patients with heart failure with reduced ejection fraction (HFrEF), an association between left atrial (LA) dilatation and dysfunction is expected, but the degree of coexistence of the two abnormalities and their relative prognostic role is not known.Methods and results: A total of 626 HFrEF patients formed the study population. All of them underwent a comprehensive echocardiographic evaluation. LA maximal volume was indexed to body surface area (LAVi); LA function was assessed using strain analysis during the reservoir phase: peak atrial longitudinal strain (PALS) analysis. Study primary endpoint was overall mortality or hospitalization for worsening heart failure. Four groups of patients were included in this study according to LAVi (≤34 or >34 mL/m2 ) and PALS (≤23% or >23%); 61 (10%) patients had normal LA volume and function (Group 1), 58 (9%) had LA dilatation but normal function (Group 2), 100 (16%) had normal volume but abnormal function (Group 3), and 407 (65%) had enlarged left atrium and abnormal function (Group 4). PALS was associated with primary endpoint in patients with both normal-size [Groups 1 and 3: hazard ratio (HR) 0.92, 95% confidence interval (CI) 0.88-0.96; P = 0.0006] and dilated left atria (Groups 2 and 4: HR 0.93, 95% CI 0.91-0.96; P < 0.0001). In contrast, LAVi was associated with the primary endpoint in patients with abnormal LA function (Groups 3 and 4: HR 1.018, 95% CI 1.011-1.024; P < 0.00001) but not in those with normal PALS (Groups 1 and 2: HR 1.023, 95% CI 0.99-1.057; P = 0.1).Conclusions: Left atrial dilatation and dysfunction frequently but not invariably coexist. PALS emerged as a significant prognostic parameter in HFrEF even in the absence of LA dilation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Heart failure
- Left atrial function
- Left atrial remodelling
- Prognosis
- kardiologi
- Cardiology
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Rossi, Andrea
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Carluccio, Erber ...
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Cameli, Matteo
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Inciardi, Riccar ...
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Mandoli, Elena G ...
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D'Agostino, Andr ...
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show more...
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Biagioli, Paolo
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Maffeis, Caterin ...
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Pugliese, Riccar ...
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Pastore, Concett ...
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Mengoni, Anna
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Pedrinelli, Robe ...
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Henein, Michael
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Dini, Frank L.
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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ESC Heart Failur ...
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Umeå University