Left atrial emptying fraction predicts limited exercise performance in heart failure patients
Autor: | Gëzim Berisha, Pranvera Ibrahimi, Michael Y. Henein, Nehat Rexhepaj, Ibadete Bytyçi, Gani Bajraktari |
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Jazyk: | angličtina |
Předmět: |
medicine.medical_specialty
Kardiologi business.industry Six-minute walk test Heart failure Exercise capacity medicine.disease Left atrial emptying function Article Text mining Left atrial Internal medicine Exercise performance cardiovascular system medicine Cardiology Physical therapy In patient Fraction (mathematics) Cardiac and Cardiovascular Systems cardiovascular diseases Cardiology and Cardiovascular Medicine business |
Zdroj: | International Journal of Cardiology. Heart & Vessels |
ISSN: | 2214-7632 |
DOI: | 10.1016/j.ijchv.2014.04.002 |
Popis: | Aim: We aimed in this study to assess the role of left atrial (LA), in addition to left ventricular (LV) indices, in predicting exercise capacity in patients with heart failure (HF). Methods: This study included 88 consecutive patients (60 ± 10 years) with stable HF. LV end-diastolic and end-systolic dimensions, ejection fraction (EF), mitral and tricuspid annulus peak systolic excursion (MAPSE and TAPSE), myocardial velocities (s′, e′ and a′), LA dimensions, LA volume and LA emptying fraction were measured. A 6-min walking test (6-MWT) distance was performed on the same day of the echocardiographic examination. Results: Patients with limited exercise performance (≤ 300 m) were older (p = 0.01), had higher NYHA functional class (p = 0.004), higher LV mass index (p = 0.003), larger LA (p = 0.002), lower LV EF (p = 0.009), larger LV end-systolic dimension (p = 0.007), higher E/A ratio (p = 0.03), reduced septal MAPSE (p < 0.001), larger LA end-systolic volume (p = 0.03), larger LA end-diastolic volume (p = 0.005) and lower LA emptying fraction (p < 0.001) compared with good performance patients. In multivariate analysis, only the LA emptying fraction [0.944 (0.898–0.993), p = 0.025] independently predicted poor exercise performance. An LA emptying fraction < 60% was 68% sensitive and 73% specific (AUC 0.73, p < 0.001) in predicting poor exercise performance. Conclusion: In heart failure patients, the impaired LA emptying function is the best predictor of poor exercise capacity. This finding highlights the need for routine LA size and function monitoring for better optimization of medical therapy in HF. |
Databáze: | OpenAIRE |
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