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Left Atrial Function Predicts Cardiovascular Events in Patients With Chronic Heart Failure With Reduced Ejection

Alessandro Malagoli1, Luca Rossi1, Francesca Bursi2

  • 1Department of Cardiology, "Guglielmo da Saliceto" Hospital, Piacenza, Italy.

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|October 15, 2018
PubMed

Insights

Left atrial function, measured by speckle-tracking echocardiography, is a key predictor of adverse outcomes in heart failure patients. Lower left atrial strain indicates a higher risk of cardiovascular events and atrial fibrillation.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Heart failure (HF) is a widespread cardiovascular disease.
  • Left atrial (LA) function is an under-examined prognostic factor in HF.
  • Chronic HF with reduced ejection fraction (HFrEF) requires better outcome prediction.

Purpose of the Study:

  • To assess LA function for predicting major cardiovascular outcomes in stable HFrEF patients.
  • To analyze cardiovascular mortality and atrial fibrillation as secondary endpoints.
  • To establish LA function as a prognostic marker in HFrEF.

Main Methods:

  • Prospective study of 286 HFrEF outpatients.
  • Evaluation of LA function using speckle-tracking echocardiography.
  • Measurement of global peak atrial longitudinal strain (PALS).

Main Results:

  • Major adverse cardiac events occurred in 34% of patients over 48 months.
  • Global PALS, left ventricular ejection fraction, and renal failure independently predicted adverse outcomes.
  • Lower PALS correlated with worse event-free survival and increased atrial fibrillation incidence.

Conclusions:

  • LA function assessed by speckle-tracking echocardiography is an independent prognostic marker in HFrEF.
  • PALS provides valuable prognostic information beyond traditional markers.
  • This technique can improve risk stratification in HFrEF management.
Abstract

Keywords:
Heart failureLeft atrial functionSpeckle trackingStrain

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