PMID- 36712283
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230202
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 9
DP  - 2022
TI  - The loss of left atrial contractile function predicts a worse outcome in HFrEF 
      patients.
PG  - 1079632
LID - 10.3389/fcvm.2022.1079632 [doi]
LID - 1079632
AB  - BACKGROUND: In chronic heart failure, high intracardiac pressures induce a 
      progressive remodeling of small pulmonary arteries up to pulmonary hypertension. 
      At the end of left atrial conduit function, pulmonary and left heart end-systolic 
      pressures equalization might affect left atrial systole. In this single-center 
      prospective study, we aimed to investigate whether peak atrial contraction strain 
      (PACS), measured by speckle tracking echocardiography, was independently 
      associated with prognosis in heart failure with reduced ejection fraction 
      (HFrEF). MATERIALS AND METHODS: Outpatients with HFrEF and sinus rhythm referred 
      to our echo-labs were enrolled. After clinical and echocardiographic evaluation, 
      off-line speckle tracking echocardiography analysis was performed. Primary and 
      secondary endpoint were cardiovascular death and heart failure hospitalization, 
      respectively. Spline knotted survival model identified the optimal prognostic 
      cut-off for PACS. RESULTS: The 152 patients were stratified based on PACS <8% (n 
      = 76) or PACS >/=8% (n = 76). Patients with PACS <8% had lower left ventricle and 
      left atrial reservoir strain and higher New York Heart Association (NYHA) class 
      and left atrial volume index (LAVI). Over a mean follow-up of 3.4 +/- 2 years, 117 
      events (51 cardiovascular death, 66 heart failure hospitalizations) were 
      collected. By univariate and multivariate Cox analysis, PACS emerged as a strong 
      and independent predictor of cardiovascular death and heart failure 
      hospitalization, after adjusting for age, sex, left ventricle strain, and E/e', 
      LAVI (HR 0.6 per 5 unit-decrease in PACS). Kaplan-Meier curves showed a sustained 
      divergence in event-free survival rates for the two groups. CONCLUSION: The 
      reduction of PACS significantly and independently affects cardiovascular outcome 
      in HFrEF. Therefore, its assessment, although limited to patients with sinus 
      rhythm, could offer additive prognostic information for HFrEF patients.
CI  - Copyright (c) 2023 Mandoli, Pastore, Benfari, Setti, Maritan, Diviggiano, 
      D'Ascenzi, Focardi, Cavigli, Valente and Cameli.
FAU - Mandoli, Giulia Elena
AU  - Mandoli GE
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Pastore, Maria Concetta
AU  - Pastore MC
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Benfari, Giovanni
AU  - Benfari G
AD  - Section of Cardiology, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Setti, Martina
AU  - Setti M
AD  - Section of Cardiology, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Maritan, Luca
AU  - Maritan L
AD  - Section of Cardiology, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Diviggiano, Enrico Emilio
AU  - Diviggiano EE
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - D'Ascenzi, Flavio
AU  - D'Ascenzi F
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Focardi, Marta
AU  - Focardi M
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Cavigli, Luna
AU  - Cavigli L
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Valente, Serafina
AU  - Valente S
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
FAU - Cameli, Matteo
AU  - Cameli M
AD  - Division of Cardiology, Department of Medical Biotechnologies, University of 
      Siena, Siena, Italy.
LA  - eng
PT  - Journal Article
DEP - 20230111
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC9874119
OTO - NOTNLM
OT  - HFrEF
OT  - heart failure
OT  - left atrium
OT  - prognosis
OT  - speckle tracking
OT  - strain
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/01/31 06:00
MHDA- 2023/01/31 06:01
PMCR- 2022/01/01
CRDT- 2023/01/30 04:00
PHST- 2022/10/25 00:00 [received]
PHST- 2022/12/21 00:00 [accepted]
PHST- 2023/01/30 04:00 [entrez]
PHST- 2023/01/31 06:00 [pubmed]
PHST- 2023/01/31 06:01 [medline]
PHST- 2022/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2022.1079632 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Jan 11;9:1079632. doi: 10.3389/fcvm.2022.1079632. 
      eCollection 2022.