PMID- 34118154
OWN - NLM
STAT- MEDLINE
DCOM- 20220603
LR  - 20220824
IS  - 2047-2412 (Electronic)
IS  - 2047-2404 (Linking)
VI  - 23
IP  - 6
DP  - 2022 Jun 1
TI  - Left atrial strain by speckle tracking predicts atrial fibrosis in patients 
      undergoing heart transplantation.
PG  - 829-835
LID - 10.1093/ehjci/jeab106 [doi]
AB  - AIMS: In patients with heart failure (HF), chronically raised left ventricular 
      (LV) filling pressures lead to progressive left atrial (LA) dysfunction and 
      fibrosis. We aimed to assess the correlation of LA reservoir strain (peak atrial 
      longitudinal strain, PALS) by speckle tracking echocardiography (STE) and LA 
      fibrosis assessed by myocardial biopsy in patients undergoing heart 
      transplantation (HTx). METHODS AND RESULTS: Forty-eight patients with advanced HF 
      [mean age 51.2 +/- 8.1 years, 29% females; LV ejection fraction </=25% and New York 
      Heart Association (NYHA) class III-IV] referred for HTx were enrolled and 
      underwent pre-operative echocardiographic evaluation, right heart 
      catheterization, and cardiopulmonary exercise testing. Exclusion criteria were 
      non-sinus rhythm, mechanical ventilation, severe mitral/tricuspid regurgitation, 
      or other valvular disease and poor acoustic window. After HTx, LA bioptic samples 
      were collected and analysed to determine the extent of myocardial fibrosis (%). 
      LA fibrosis showed correlation with PALS (R = -0.88, P < 0.0001), VO2max 
      (R = -0.68, P < 0.0001), NYHA class (R = 0.66, P < 0.0001), LA stiffness 
      (R = 0.58, P = 0.0002), and E/e' (R = 0.44, P = 0.005), while poorly correlated 
      with E/A ratio (R = 0.23, P = 0.21). PALS had a good correlation with NYHA class 
      (R = -0.64, P < 0.0001), PAoP (R = -0.61, P = 0.03) and VO2max (R = 0.57, 
      P = 0.0001). Multivariate regression analysis identified PALS (beta = -0.91, 
      P < 0.001) and LA Volume (beta = -0.19, P = 0.03) as predictors of LA Fibrosis, 
      while E/e' was not a significant predictor (beta = 0.15, P = 0.08). CONCLUSION: 
      Emerging as a possible index of myocardial fibrosis in patients with advanced HF, 
      PALS could help to optimize the management and the selection of those patients 
      with irreversible LA structural damage for advanced therapeutic strategies.
CI  - Published on behalf of the European Society of Cardiology. All rights reserved. (c) 
      The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.
FAU - Lisi, Matteo
AU  - Lisi M
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
AD  - Division of Cardiology, Department of Cardiovascular Disease-AUSL Romagna, 
      Ospedale S. Maria delle Croci, Ravenna, Italy.
AD  - Department of Public Health and Clinical Medicine, Umea University and Heart 
      Centre, Umea, Sweden.
FAU - Mandoli, Giulia Elena
AU  - Mandoli GE
AUID- ORCID: 0000-0002-3184-3006
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Cameli, Matteo
AU  - Cameli M
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Pastore, Maria Concetta
AU  - Pastore MC
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Righini, Francesca Maria
AU  - Righini FM
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Benfari, Giovanni
AU  - Benfari G
AD  - Division of Cardiology, University of Verona, Verona, Italy.
FAU - Rubboli, Andrea
AU  - Rubboli A
AD  - Division of Cardiology, Department of Cardiovascular Disease-AUSL Romagna, 
      Ospedale S. Maria delle Croci, Ravenna, Italy.
FAU - D'Ascenzi, Flavio
AU  - D'Ascenzi F
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Focardi, Marta
AU  - Focardi M
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Tsioulpas, Charilaos
AU  - Tsioulpas C
AD  - Department of Cardiac Surgery, University of Siena, Siena, Italy.
FAU - Bernazzali, Sonia
AU  - Bernazzali S
AD  - Department of Cardiac Surgery, University of Siena, Siena, Italy.
FAU - Maccherini, Massimo
AU  - Maccherini M
AD  - Department of Cardiac Surgery, University of Siena, Siena, Italy.
FAU - Lisi, Edoardo
AU  - Lisi E
AD  - Department of Mathematics, Imperial College London, London, UK.
FAU - Lindqvist, Per
AU  - Lindqvist P
AD  - Department of Public Health and Clinical Medicine, Umea University and Heart 
      Centre, Umea, Sweden.
FAU - Valente, Serafina
AU  - Valente S
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Mondillo, Sergio
AU  - Mondillo S
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Viale Bracci n degrees  1, 53100 Siena, Italy.
FAU - Henein, Michael Y
AU  - Henein MY
AD  - Department of Public Health and Clinical Medicine, Umea University and Heart 
      Centre, Umea, Sweden.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Eur Heart J Cardiovasc Imaging
JT  - European heart journal. Cardiovascular Imaging
JID - 101573788
SB  - IM
MH  - Adult
MH  - Echocardiography/methods
MH  - Female
MH  - Fibrosis
MH  - Heart Atria/diagnostic imaging
MH  - *Heart Failure/diagnostic imaging/surgery
MH  - *Heart Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Stroke Volume
OTO - NOTNLM
OT  - fibrosis
OT  - heart failure
OT  - heart transplantation
OT  - left atrial
OT  - speckle tracking
OT  - strain
EDAT- 2021/06/13 06:00
MHDA- 2022/06/07 06:00
CRDT- 2021/06/12 17:03
PHST- 2021/05/13 00:00 [received]
PHST- 2021/05/13 00:00 [accepted]
PHST- 2021/06/13 06:00 [pubmed]
PHST- 2022/06/07 06:00 [medline]
PHST- 2021/06/12 17:03 [entrez]
AID - 6297503 [pii]
AID - 10.1093/ehjci/jeab106 [doi]
PST - ppublish
SO  - Eur Heart J Cardiovasc Imaging. 2022 Jun 1;23(6):829-835. doi: 
      10.1093/ehjci/jeab106.