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Left atrial changes in early stages of heart failure with preserved ejection fraction

Ibadete Bytyçi1, Gani Bajraktari2,3

  • 1Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Republic of Kosovo. i.bytyci@hotmail.com.

Echocardiography (Mount Kisco, N.Y.)
|July 30, 2016
PubMed

Insights

Heart failure with preserved ejection fraction (HFpEF) patients show early left atrial (LA) dysfunction, including reduced LA emptying fraction and increased LA mass, even with normal LA size. This indicates a need for timely therapeutic interventions.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Left atrial (LA) mass increases as a compensatory mechanism in heart failure (HF).
  • Atrial conduction time and LA emptying fraction are impaired in HF with preserved ejection fraction (HFpEF).

Purpose of the Study:

  • To evaluate early changes in the left atrium (LA) of patients diagnosed with HFpEF.

Main Methods:

  • Echocardiographic assessment of 79 HFpEF patients (NYHA class I-III, LV EF ≥45%) and 29 controls.
  • Patients were stratified into mild and moderate diastolic dysfunction (DD) groups based on echocardiographic findings.

Main Results:

  • HFpEF patients exhibited increased left ventricular (LV) mass and reduced mitral annular plane systolic excursion (MAPSE).
  • Significant increases in LA mass and minimal volume, alongside decreased LA emptying fraction and worsened LA dyssynchrony, were observed in HFpEF patients with mild and moderate DD compared to controls.
  • These alterations occurred despite normal LA dimensions in early stages.

Conclusions:

  • Early-stage HFpEF is characterized by LV hypertrophy and impaired LV longitudinal systolic function.
  • Left atrial (LA) function deteriorates early in HFpEF, evidenced by reduced LA emptying fraction, increased LA mass, and significant LA dyssynchrony, even when LA dimensions remain normal.
  • These findings underscore the necessity for prompt and effective therapeutic strategies in managing HFpEF to address early LA dysfunction.
Abstract

Keywords:
diastolic dysfunctionheart failureleft atrial dyssynchronyleft atrial emptying fractionleft atrial mass

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