Left Atrial Strain Associated with Functional Recovery in Patients Receiving Optimal Treatment for Heart Failure - 03/09/21
, Yukina Hirata, PhD a, Susumu Nishio, PhD a, Takayuki Ise, MD, PhD b, Koji Yamaguchi, MD, PhD b, Daiju Fukuda, MD, PhD b, Shusuke Yagi, MD, PhD b, Hirotsugu Yamada, MD, PhD c, Takeshi Soeki, MD, PhD b, Tetsuzo Wakatsuki, MD, PhD b, Masataka Sata, MD, PhD bAbstract |
Background |
Heart failure with recovered ejection fraction (HFrecEF) has been reported in several previous studies to have a better prognosis than heart failure with reduced ejection fraction (HFrEF). However, the factors associated with HFrecEF have not been identified. The aim of this study was to test the hypothesis that left atrial (LA) strain could help identify patients with recovered ejection fraction (EF) among those with heart failure (HF) with low EF on admission.
Methods |
One hundred consecutive patients hospitalized for the first time for new-onset HF were enrolled. Patients were clinically diagnosed with HFrEF on admission (left ventricular EF < 40%) and received optimal treatment for HF. Twenty-eight patients improved to HFrecEF during 6 months of follow-up.
Results |
Regarding clinical background, there were significantly more women and a lower rate of atrial fibrillation in the HFrecEF group than in the HFrEF group. In a multivariate logistic regression analysis, LA strain was an independent predictor of HFrecEF, even after adjustment for gender and left ventricular EF (odds ratio: 4.06; 95% CI: 2.04–8.07; P < .001). A cutoff value of 10.8% for LA strain showed high sensitivity (96%) and specificity (82%) in identifying HFrecEF in patients with HF presenting with low EF on admission. During a follow-up period of 24 ± 13 months, 31 patients (31%) had cardiovascular death or readmission for HF. Patients with reduced LA strain (<10.8%) had significantly shorter event-free survival than those with preserved LA strain (P = .02).
Conclusions |
LA strain is a useful indicator for predicting HFrecEF and should be considered as a routine measurement in patients with HFrEF on admission.
Le texte complet de cet article est disponible en PDF.Highlights |
• | LA strain at admission predicts HFrecEF in patients with optimal treatments of HF. |
• | LA strain could be a predictor of EF changes and subsequent CV death in HFrecEF. |
• | LA strain should be considered in patients with low ejection fractions on admission. |
Keywords : Heart failure with reduced ejection fraction, Heart failure with recovered ejection fraction, Left atrial strain
Abbreviations : AF, CV, GLS, HF, HFrecEF, HFrEF, LA, LAEF, LV, LVEF, RV, STE
Plan
| This work was partially supported by a Japan Society for the Promotion of Science KAKENHI grant (17K13037 to Dr. Hirata) and the Takeda Science Foundation (to Dr. Kusunose). |
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| Conflicts of interest: None. |
Vol 34 - N° 9
P. 966 - septembre 2021 Retour au numéro
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