131Left atrial phasic function in heart failure with preserved ejection fraction: cardiac magnetic resonance myocardial feature tracking, invasive hemodynamics and outcome

Autor: Julia Mascherbauer, Andreas A. Kammerlander, Lukas Fiedler, Franz Duca, Caroline Zotter-Tufaro, Stefan Aschauer, Franz X. Roithinger, Christian Hengstenberg, Christian Nitsche, Diana Bonderman, Christian Loewe, Christoph J. Binder, R Schoenbauer
Rok vydání: 2019
Předmět:
Zdroj: European Heart Journal. 40
ISSN: 1522-9645
0195-668X
DOI: 10.1093/eurheartj/ehz747.0047
Popis: Background Global left atrial (LA) size and function have been shown to be associated with adverse events in heart failure with preserved ejection fraction (HFpEF). The machanism of coupling from left heart failure to pulmonary circulation is still controversially discussed. Purpose To study the prognostic most relevant determinant of LA size and function and its backward and forward interplay. Methods 188 HFpEF patients were prospectively enrolled and underwent baseline clinical assessment, cardiac magnetic resonance imaging (CMR) and invasive hemodynamic assessment. Coronary artery disease was ruled out by coronary angiography. 92 patients were in atrial fibrillation (AF), 96 in sinus rhythm. LA size and function were assessed by CMR including LA strain imaging by myocardial feature tracking (Figure 1A & B). Results Patients in AF had more pronounced dilatation of all phasic LA volumes and reduction of all phasic LA functions when compared to sinus rhythm (each p After 31 (9–57) months 66 patients reached the combined endpoint defined as combination from hospitalization due to heart failure and cardiovascular death. In AF no atrial functional or volume parameter was correlated to outcome. In contrast in sinus rhythm several phasic LA volume and functional parameters were associated with outcome. After multivariate cox regression analysis only reduced total LA ejection fraction and conduit strain rate were still predictive for worse outcome (p=0.031 and Conclusion Total LA ejection fraction plays a key role in the prognosis of HFpEF. This effect seems to be mainly related to its LA conduit function but not to LA booster pump function. LA conduit function correlates to impaired 6MWD, sPAP and PVR.
Databáze: OpenAIRE
Externí odkaz: