Association Between Left Atrial Stiffness Index and Clinical Outcomes in Chronic Heart Failure With Impaired Left...

Area of Science:

• Cardiology
• Echocardiography
• Heart Failure Research

Background:

• Left atrial (LA) stiffness reflects LA mechanical properties and left ventricular (LV) filling dynamics, potentially assessing cardiac hemodynamic burden.
• The clinical significance of LA stiffness in chronic heart failure (HF) with impaired LV systolic function is not well-established.

Purpose of the Study:

• To investigate the association between the LA stiffness index (LASI) and clinical outcomes in patients with chronic HF and impaired LV systolic function.
• To determine if LASI can serve as a practical echocardiographic marker for atrial dysfunction and hemodynamic burden.

Main Methods:

• Retrospective analysis of 1,147 patients with chronic HF and LVEF <50% undergoing echocardiography.
• LASI calculated as E/e' to LA reservoir strain ratio, stratified into tertiles.
• Primary endpoint: composite of cardiovascular death or HF hospitalization; analyzed using Kaplan-Meier and Cox proportional hazards models.

Main Results:

• Higher LASI was independently associated with adverse outcomes (HR 2.41, P < 0.01) after multivariable adjustment.
• Event-free survival decreased progressively across LASI tertiles (P < 0.01).
• Association remained consistent across subgroups (age, diabetes, LV geometry, LA size).

Conclusions:

• Increased LASI is independently associated with cardiovascular death and HF hospitalization in chronic HF patients with impaired LV systolic function.
• LASI may be a valuable echocardiographic tool for evaluating atrial dysfunction and hemodynamic burden in this population.