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Impaired left atrial function in heart failure with preserved ejection fraction.
Angela B S Santos1, Elisabeth Kraigher-Krainer, Deepak K Gupta
1Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, USA; Postgraduate Program in Cardiovascular Sciences, Cardiology, Federal University of Rio Grande do Sul, Brazil.
European Journal of Heart Failure
|August 21, 2014
Summary
Heart failure with preserved ejection fraction (HFpEF) patients show impaired left atrial (LA) function, regardless of LA size or atrial fibrillation history. This dysfunction may indicate HFpEF severity and contribute to its pathology.
Area of Science:
- Cardiology
- Cardiac Physiology
- Echocardiography
Background:
- Left atrial (LA) enlargement is common in heart failure with preserved ejection fraction (HFpEF) and signifies risk.
- The role of LA function in HFpEF pathophysiology remains incompletely understood.
Purpose of the Study:
- To investigate the functional status of the left atrium in patients with HFpEF.
- To determine if LA dysfunction is associated with clinical characteristics, cardiac structure, and function in HFpEF.
Main Methods:
- The study analyzed 135 HFpEF patients and 40 controls using two-dimensional volume indices and speckle tracking echocardiography.
- LA reservoir, conduit, and pump function were assessed, with a focus on systolic LA strain.
Main Results:
- HFpEF patients exhibited significantly worse LA reservoir, conduit, and pump function compared to controls.
- Reduced systolic LA strain in HFpEF persisted even in patients with normal LA size or no history of atrial fibrillation.
- Lower systolic LA strain correlated with increased HF hospitalizations, atrial fibrillation history, impaired LV systolic function, and increased LV mass and LA volume.
Conclusions:
- All phases of LA function are impaired in HFpEF patients.
- Systolic LA strain is reduced in HFpEF, independent of LA size or atrial fibrillation history.
- LA dysfunction may serve as a marker of HFpEF severity and play a role in its pathogenesis.
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