Left atrial function in heart failure with mid-range ejection fraction differs from that of heart failure with preserved ejection fraction: a 2D speckle-tracking echocardiographic study
File(s)manuscript_amened_cleaned.docx (236.65 KB)
Accepted version
Author(s)
Al Saikhan, Lamia
Hughes, Alun D
Chung, Wing-See
Alsharqi, Maryam
Nihoyannopoulos, Petros
Type
Journal Article
Abstract
Aims: Heart failure (HF) with mid-range ejection fraction (HFmrEF) shares similar diagnostic criteria to HF with preserved ejection fraction (HFpEF). Whether left atrial (LA) function differs between HFmrEF and HFpEF is unknown. We, therefore, used 2D-speckle-tracking echocardiography (2D-STE) to assess LA phasic function in patients with HFpEF and HFmrEF. Methods and results: Consecutive outpatients diagnosed with HF according to current European recommendations were prospectively enrolled. There were 110 HFpEF and 61 HFmrEF patients with sinus rhythm, and 37 controls matched by age. LA phasic function was analysed using 2D-STE. Peak-atrial longitudinal strain (PALS), peak-atrial contraction strain (PACS), and PALS-PACS were measured reflecting LA reservoir, pump, and conduit function, respectively. Among HF groups, most of left ventricular (LV) diastolic function measures, and LA volume were similar. Both HF groups had abnormal LA phasic function compared with controls. HFmrEF patients had worse LA phasic function than HFpEF patients even among patients with LA enlargement. Among patients with normal LA size, LA reservoir, and pump function remained worse in HFmrEF. Differences in LA phasic function between HF groups remained significant after adjustment for confounders. Global PALS and PACS were inversely correlated with brain natriuretic peptide, LA volume, E/A, E/e', pulmonary artery systolic pressure, and diastolic dysfunction grade in both HF groups. Conclusion: LA phasic function was worse in HFmrEF patients compared with those with HFpEF regardless of LA size, and independent of potential confounders. These differences could be attributed to intrinsic LA myocardial dysfunction perhaps in relation to altered LV function.
Date Issued
2019-03-01
Date Acceptance
2018-11-17
Citation
EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging, 2019, 20 (3), pp.279-290
ISSN
2047-2412
Publisher
Oxford University Press (OUP)
Start Page
279
End Page
290
Journal / Book Title
EHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imaging
Volume
20
Issue
3
Copyright Statement
© 2018 Oxford University Press. This is a pre-copy-editing, author-produced version of an article accepted for publication in European Heart Journal - Cardiovascular Imaging following peer review. The definitive publisher-authenticated version (Lamia Al Saikhan, Alun D Hughes, Wing-See Chung, Maryam Alsharqi, Petros Nihoyannopoulos; Left atrial function in heart failure with mid-range ejection fraction differs from that of heart failure with preserved ejection fraction: a 2D speckle-tracking echocardiographic study, European Heart Journal - Cardiovascular Imaging, , jey171) is available online at: https://dx.doi.org/10.1093/ehjci/jey171.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/30517648
PII: 5229556
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Radiology, Nuclear Medicine & Medical Imaging
Cardiovascular System & Cardiology
atrial strain
HFmrEF
HFpEF
speckle-tracking echocardiography
EUROPEAN ASSOCIATION
NATRIURETIC PEPTIDE
AMERICAN SOCIETY
TASK-FORCE
RECOMMENDATIONS
DYSFUNCTION
PREVALENCE
UPDATE
STRAIN
HFmrEF
HFpEF
atrial strain
speckle-tracking echocardiography
Aged
Analysis of Variance
Atrial Function, Left
Case-Control Studies
Cohort Studies
Echocardiography
Female
Heart Failure
Humans
Image Interpretation, Computer-Assisted
Linear Models
Male
Middle Aged
Multivariate Analysis
Severity of Illness Index
Statistics, Nonparametric
Stroke Volume
Humans
Image Interpretation, Computer-Assisted
Echocardiography
Stroke Volume
Severity of Illness Index
Analysis of Variance
Multivariate Analysis
Linear Models
Statistics, Nonparametric
Case-Control Studies
Cohort Studies
Atrial Function, Left
Aged
Middle Aged
Female
Male
Heart Failure
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2018-12-04