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Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in
Qingfeng Zhang1,2, Sijia Wang1,2, Hongmei Zhang2
1School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Insights
Left atrial stiffness index (LASI) is linked to exercise capacity in hypertension-related heart failure with preserved ejection fraction (HT-HFpEF). E/e'/LASr effectively predicts exercise intolerance in these patients.
Area of Science:
- Cardiology
- Cardiovascular Physiology
- Medical Imaging
Background:
- Left atrial stiffness index (LASI) is crucial for atrioventricular coupling and heart failure progression.
- Hypertension-related heart failure with preserved ejection fraction (HT-HFpEF) presents unique challenges in assessing cardiac function and exercise capacity.
Purpose of the Study:
- To assess left atrial function in patients with HT-HFpEF.
- To evaluate the relationship between LASI and exercise capacity in HT-HFpEF.
- To investigate the predictive value of LASI for exercise intolerance.
Main Methods:
- Involved 62 healthy subjects and 163 patients with hypertension (HT), including 51 with HT-HFpEF.
- Utilized exercise stress tests and standard ultrasonic imaging.
- Assessed atrioventricular function and correlated parameters with exercise capacity, including LASI (E/e'/LASr and E/e'/LASr-c).
Main Results:
- HT patients showed increased left atrial volume and decreased strain compared to healthy subjects.
- HT-HFpEF patients exhibited significant reductions in longitudinal and circumferential strain.
- E/e'/LASr and E/e'/LASr-c correlated significantly with metabolic equivalents (METs).
- E/e'/LASr showed comparable diagnostic efficacy to exercise-E/e' for assessing exercise intolerance.
Conclusions:
- Progressive left atrial remodeling decreases atrioventricular compliance in HT and HT-HFpEF.
- E/e'/LASr is an independent indicator of exercise intolerance in HT-HFpEF patients.
Objective:
The left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertension-related heart failure with preserved ejection fraction (HT-HFpEF).
Methods:
The study involved 62 healthy subjects and 163 patients with HT (112 patients in simple HT group and 51 patients in HT-HFpEF group). Each patient performed exercise stress test and standard ultrasonic images were evaluated. A comprehensive evaluation of atrioventricular function, along with investigation into the correlation between these functional parameters and exercise capacity. And further to investigate the feasibility of predicting exercise intolerance using three-dimensional derived left atrial strain index (LASI) (E/e'/LASr and E/e'/LASr-c).
Results:
Compared to healthy subjects, HT group demonstrated the elevation in left atrial volume accompanied by decrease in strain value (P < 0.05). In HT-HFpEF group, further significant reductions were observed in both longitudinal (LASr) and circumferential strain (LASr-c, LASct-c) (P < 0.05). Univariate regression demonstrated that both E/e'/LASr and E/e'/LASr-c were significantly correlated with metabolic equivalents (METs) (r = -0.462, P < 0.001; r = -0.381, P < 0.001). The E/e'/LASr demonstrates comparable diagnostic efficacy to exercise-E/e' in assessing exercise intolerance in HT-HFpEF patients (AUC: 0.836 vs. 0.867, P = 0.239).
Conclusion:
Progressive LA remodeling contributes to decreased atrioventricular compliance in HT and HT-HFpEF patients.E/e'/LASr serves as an independent indicator of exercise intolerance in patients with HT-HFpEF.
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