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Left Atrial Structure and Function in Heart Failure with Preserved Ejection Fraction: A RELAX Substudy.
Siddique A Abbasi1, Ravi V Shah2, Steven E McNulty3
1Non-Invasive Cardiovascular Imaging Section, Brigham and Women's Hospital, Boston, MA, United States of America.
Plos One
|November 5, 2016
Summary
Left atrial volume and function in heart failure with preserved ejection fraction (HF-pEF) are linked to disease severity markers like NT-proBNP and diastolic properties, not exercise capacity. Further research is needed.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Heart Failure Research
Background:
- Left atrial (LA) structure and function are increasingly recognized as crucial indicators in heart failure with preserved ejection fraction (HF-pEF).
- Understanding the relationship between LA characteristics and disease severity markers is vital for improving patient management in HF-pEF.
Purpose of the Study:
- To investigate the association between left atrial volume and function with markers of disease severity and cardiac structure in patients with HF-pEF.
- To explore the correlation of LA metrics with clinical status and exercise capacity.
Main Methods:
- Cardiac magnetic resonance (CMR) was used to quantify maximal left atrial volume index (LAVi) and left atrial emptying fraction (LAEF) in 100 HF-pEF patients.
- Cardiopulmonary exercise testing and blood collection for NT-proBNP were performed.
- Statistical analyses, including adjustments for multiple testing, were conducted to determine associations.
Main Results:
- Maximal LAVi was associated with age, transmitral filling patterns (E/e'), and NT-proBNP.
- Lower LAEF correlated with older age, higher transmitral E/A ratio, and higher NT-proBNP.
- Peak VO2 and VE/VCO2 slope showed no significant association with LA structure or function.
Conclusions:
- Left atrial volume and emptying function in HF-pEF are primarily associated with NT-proBNP and diastolic filling properties.
- These LA characteristics are not significantly associated with gas exchange markers of exercise capacity in this population.
- Further research is warranted to fully elucidate the clinical relevance of LA structure and function in HF-pEF.
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