PMID- 36769734
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230214
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 12
IP  - 3
DP  - 2023 Jan 30
TI  - Left Atrial Functional Remodeling in Patients with Chronic Heart Failure Treated 
      with Sacubitril/Valsartan.
LID - 10.3390/jcm12031086 [doi]
LID - 1086
AB  - (1) Background: Previous studies showed left ventricular (LV) and left atrial 
      (LA) improvement and reverse remodeling after therapy with Sacubitril/Valsartan 
      (S/V) in patients affected by heart failure with reduced ejection fraction 
      (HFrEF). Therefore, we sought to investigate predictors of LA structural and 
      functional reverse remodeling (LARR) in this setting of patients after therapy 
      with S/V, focusing on left atrial strain parameters, such as peak atrial 
      longitudinal strain (PALS). (2) Methods: Patients with HFrEF underwent clinical 
      and echocardiographic evaluation at baseline and after six months of therapy with 
      S/V. Measures of LA structure (LA volume index, LAVi) and function (LA emptying 
      fraction (LAEF), PALS, LA conduit strain and peak atrial contraction strain 
      (PACS) were also analyzed. Patients were divided in two groups, those with a LARR 
      (relative reduction in LAVi > 15%, LARR+) and those without (LARR-). (3) Results: 
      A total of 47 consecutive patients (66 +/- 8 years, 85% male, mean LVEF 28 +/- 6%) 
      were enrolled in the study and followed up. A significant increase of LAEF (46 +/- 
      13 vs. 37 +/- 11%, p < 0.001) and a significant reduction of LAVi (42 +/- 15 vs. 45 +/- 
      15 mL/m(2), p = 0.008) were found after 6 months of S/V therapy; 47% of the 
      population showed LA reverse remodeling. LA strain parameters, PALS (19 +/- 8 vs. 
      15 +/- 7 %, p < 0.001) and LA conduit (-9.7 +/- 5.2% vs. -7.6 +/- 4.1%, p = 0.007) 
      significantly improved after 6 months of S/V therapy. At multivariable stepwise 
      regression analysis, changes in LV End Diastolic Volume (LVEDV) and PALS were 
      significantly proportional to changes in LAVi values. (4) Conclusions: Six months 
      of treatment with S/V in patients with HFrEF was associated with an improvement 
      in LA functional reverse remodeling in a real-world scenario. LARR was not 
      significantly correlated to baseline echocardiographic variables, but was 
      proportional to changes in LV volumes and LA strain parameters. Finally, after 
      S/V therapy, a strict connection between LA and LV reverse remodeling and between 
      LA anatomical and functional reverse remodeling seems to be outlined.
FAU - Correale, Michele
AU  - Correale M
AUID- ORCID: 0000-0002-7863-253X
AD  - Cardiology Unit, Cardio-Thoracic Department, Policlinico Riuniti University 
      Hospital, Viale Luigi Pinto 1, 71100 Foggia, Italy.
FAU - Magnesa, Michele
AU  - Magnesa M
AUID- ORCID: 0000-0003-2058-6865
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Mazzeo, Pietro
AU  - Mazzeo P
AUID- ORCID: 0000-0002-4683-4639
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Fortunato, Martino
AU  - Fortunato M
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Tricarico, Lucia
AU  - Tricarico L
AUID- ORCID: 0000-0003-4461-1885
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Leopizzi, Alessandra
AU  - Leopizzi A
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Mallardi, Adriana
AU  - Mallardi A
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Mennella, Raffaele
AU  - Mennella R
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Croella, Francesca
AU  - Croella F
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Iacoviello, Massimo
AU  - Iacoviello M
AUID- ORCID: 0000-0001-9613-5062
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Di Biase, Matteo
AU  - Di Biase M
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
FAU - Brunetti, Natale Daniele
AU  - Brunetti ND
AD  - Department of Medical and Surgical Sciences, University of Foggia, 71100 Foggia, 
      Italy.
LA  - eng
PT  - Journal Article
DEP - 20230130
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC9917469
OTO - NOTNLM
OT  - ARNI
OT  - cardiac reverse remodeling
OT  - chronic heart failure reduced ejection fraction
OT  - left atrial function
OT  - left atrial strain
OT  - sacubitril/valsartan
COIS- The authors declare no conflict of interest. The funders had no role in the 
      design of the study; in the collection, analyses or interpretation of data; in 
      the writing of the manuscript or in the decision to publish the results.
EDAT- 2023/02/12 06:00
MHDA- 2023/02/12 06:01
PMCR- 2023/01/30
CRDT- 2023/02/11 01:28
PHST- 2022/12/08 00:00 [received]
PHST- 2023/01/17 00:00 [revised]
PHST- 2023/01/23 00:00 [accepted]
PHST- 2023/02/11 01:28 [entrez]
PHST- 2023/02/12 06:00 [pubmed]
PHST- 2023/02/12 06:01 [medline]
PHST- 2023/01/30 00:00 [pmc-release]
AID - jcm12031086 [pii]
AID - jcm-12-01086 [pii]
AID - 10.3390/jcm12031086 [doi]
PST - epublish
SO  - J Clin Med. 2023 Jan 30;12(3):1086. doi: 10.3390/jcm12031086.