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Lumped-Parameter and Finite Element Modeling of Heart Failure with Preserved Ejection Fraction
Published on: February 13, 2021
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Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta-analysis
Muhammad Shahzeb Khan1, Muhammad Mustafa Memon2, Mohammad H Murad3
1Department of Internal Medicine, John H Stroger Jr. Hospital of Cook County, Chicago, IL, USA.
European Journal of Heart Failure
|January 11, 2020
Summary
Impaired left atrial (LA) mechanical function is common in heart failure with preserved ejection fraction (HFpEF). Reduced LA reservoir strain predicts adverse outcomes like mortality and hospitalization in HFpEF patients.
Area of Science:
- Cardiology
- Cardiovascular Research
- Medical Diagnostics
Background:
- Left atrial (LA) mechanical function is increasingly recognized for its role in the pathophysiology of heart failure with preserved ejection fraction (HFpEF).
- Understanding LA function's impact is crucial for diagnosing and managing HFpEF, a complex clinical syndrome.
Purpose of the Study:
- To systematically review and meta-analyze the association between impaired LA mechanical function and clinical outcomes in patients with HFpEF.
- To evaluate the diagnostic and prognostic utility of various LA function indices in HFpEF.
Main Methods:
- A systematic review and meta-analysis of 22 studies (1974 HFpEF patients, 751 controls) were conducted.
- LA function parameters (reservoir, conduit, pump emptying fractions and strains) were compared between HFpEF patients and healthy controls.
- Prognostic value was assessed by pooling adjusted hazard ratios for adverse outcomes.
Main Results:
- HFpEF patients exhibited significantly decreased LA reservoir, conduit, and pump emptying fractions compared to controls.
- LA reservoir, conduit, and pump strains were also significantly lower in the HFpEF cohort.
- Reduced LA reservoir strain was significantly associated with an increased risk of composite all-cause mortality or heart failure hospitalization (HR 1.24).
Conclusions:
- Impaired LA function demonstrates potential diagnostic and prognostic value in HFpEF.
- Further research with larger studies is required to fully determine LA function's role in refining diagnosis and prognosis.
- Investigating LA function as a therapeutic target for novel HFpEF treatments is warranted.
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