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Left ventricular fi...
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Mandoli, Giulia ElenaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
(author)
Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure
- Article/chapterEnglish2024
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Oxford University Press,2024
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LIBRIS-ID:oai:DiVA.org:umu-223228
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https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-223228URI
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https://doi.org/10.1093/ehjci/jead340DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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Aims: Advanced heart failure (AdHF) is characterized by variable degrees of left ventricular (LV) dysfunction, myocardial fibrosis, and raised filling pressures which lead to left atrial (LA) dilatation and cavity dysfunction. This study investigated the relationship between LA peak atrial longitudinal strain (PALS), assessed by speckle-tracking echocardiography (STE), and invasive measures of LV filling pressures and fibrosis in a group of AdHF patients undergoing heart transplantation (HTX).Methods and results: We consecutively enrolled patients with AdHF who underwent HTX at our Department. Demographic and basic echocardiographic data were registered, then invasive intracardiac pressures were obtained from right heart catheterization, and STE was also performed. After HTX, biopsy specimens from explanted hearts were collected to quantify the degree of LV myocardial fibrosis. Sixty-four patients were included in the study (mean age 62.5 ± 11 years, 42% female). The mean LV ejection fraction (LVEF) was 26.7 ± 6.1%, global PALS was 9.65 ± 4.5%, and mean pulmonary capillary wedge pressure (PCWP) was 18.8 ± 4.8 mmHg. Seventy-three % of patients proved to have severe LV fibrosis. Global PALS was inversely correlated with PCWP (R = −0.83; P < 0.0001) and with LV fibrosis severity (R = −0.78; P < 0.0001) but did not correlate with LVEF (R = 0.15; P = 0.2). Among echocardiographic indices of LV filling pressures, global PALS proved the strongest [area under the curve 0.955 (95% confidence interval 0.87–0.99)] predictor of raised (>18 mmHg) PCWP.Conclusion: In patients with AdHF, reduced global PALS strongly correlated with the invasively assessed LV filling pressure and degree of LV fibrosis. Such relationship could be used as non-invasive indicator for optimum patient stratification for therapeutic strategies.
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Cameli, MatteoDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
(author)
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Pastore, Maria ConcettaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
(author)
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Loiacono, FerdinandoDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
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Righini, Francesca MariaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
(author)
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D’Ascenzi, FlavioDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
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Focardi, MartaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
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Cavigli, LunaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
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Lisi, MatteoDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy; Division of Cardiology, Department of Cardiovascular Diseases—AUSL Romagna, ‘Santa Maria delle Croci’ Hospital, Ravenna, Italy
(author)
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Bisleri, GianluigiCardiac Surgery, St. Michael Hospital, ON, Toronto, Canada
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Dokollari, AleksanderCardiac Surgery, St. Michael Hospital, ON, Toronto, Canada
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Bernazzali, SoniaDepartment of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Maccherini, MassimoDepartment of Cardiac Surgery, Azienda Ospedaliera Universitaria Senese, Siena, Italy
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Valente, SerafinaDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy
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Henein, Michael Y.Umeå universitet,Institutionen för folkhälsa och klinisk medicin(Swepub:umu)mihe0015
(author)
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Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, ItalyDepartment of Medical Biotechnologies, Division of Cardiology, University of Siena, Viale Mario Bracci, 1, Siena, Italy; Division of Cardiology, Department of Cardiovascular Diseases—AUSL Romagna, ‘Santa Maria delle Croci’ Hospital, Ravenna, Italy
(creator_code:org_t)
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In:European Heart Journal Cardiovascular Imaging: Oxford University Press25:4, s. 446-4532047-24042047-2412
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