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Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis

Left atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF....

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Autores principales: Jin, Xuanyi, Nauta, Jan F., Hung, Chung-Lieh, Ouwerkerk, Wouter, Teng, Tiew-Hwa Katherine, Voors, Adriaan A., Lam, Carolyn SP., van Melle, Joost P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9388424/
https://www.ncbi.nlm.nih.gov/pubmed/35079942
http://dx.doi.org/10.1007/s10741-021-10204-8
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author Jin, Xuanyi
Nauta, Jan F.
Hung, Chung-Lieh
Ouwerkerk, Wouter
Teng, Tiew-Hwa Katherine
Voors, Adriaan A.
Lam, Carolyn SP.
van Melle, Joost P.
author_facet Jin, Xuanyi
Nauta, Jan F.
Hung, Chung-Lieh
Ouwerkerk, Wouter
Teng, Tiew-Hwa Katherine
Voors, Adriaan A.
Lam, Carolyn SP.
van Melle, Joost P.
author_sort Jin, Xuanyi
collection PubMed
description Left atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF. English literature on LA structure and function using echocardiography was reviewed to calculate pooled prevalence and weighted mean differences (WMD). A total of 61 studies, comprising 8806 patients with HFrEF and 9928 patients with HFpEF, were included. The pooled prevalence of atrial fibrillation (AF) was 34.4% versus 42.8% in the acute inpatient setting, and 20.1% versus 33.1% in the chronic outpatient setting when comparing between HFrEF and HFpEF. LA volume index (LAVi), LA reservoir global longitudinal strain (LAGLS(R)), and E/e’ was 59.7 versus 52.7 ml/m(2), 9.0% versus 18.9%, and 18.5 versus 14.0 in the acute inpatient setting, and 48.3 versus 38.2 ml/m(2), 12.8% versus 23.4%, and 16.9 versus 13.5 in the chronic outpatient setting when comparing HFrEF versus HFpEF, respectively. The relationship between LAVi and LAGLS(R) was significant in HFpEF, but not in HFrEF. Also, in those studies that directly compared patients with HFrEF versus HFpEF, those with HFrEF had worse LAGLS(R) [WMD = 16.3% (22.05,8.61); p < 0.001], and higher E/e’ [WMD = −0.40 (−0.56, −0.24); p < 0.05], while LAVi was comparable. When focusing on acute hospitalized patients, E/e’ was comparable between patients with HFrEF and HFpEF. Despite the higher burden of AF in HFpEF, patients with HFrEF had worse LA global function. Left atrial myopathy is not specifically related to HFpEF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10741-021-10204-8.
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spelling pubmed-93884242022-08-20 Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis Jin, Xuanyi Nauta, Jan F. Hung, Chung-Lieh Ouwerkerk, Wouter Teng, Tiew-Hwa Katherine Voors, Adriaan A. Lam, Carolyn SP. van Melle, Joost P. Heart Fail Rev Article Left atrial (LA) structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF) is only established in small studies. Therefore, we conducted a systematic review of LA structure and function in order to find differences between patients with HFrEF and HFpEF. English literature on LA structure and function using echocardiography was reviewed to calculate pooled prevalence and weighted mean differences (WMD). A total of 61 studies, comprising 8806 patients with HFrEF and 9928 patients with HFpEF, were included. The pooled prevalence of atrial fibrillation (AF) was 34.4% versus 42.8% in the acute inpatient setting, and 20.1% versus 33.1% in the chronic outpatient setting when comparing between HFrEF and HFpEF. LA volume index (LAVi), LA reservoir global longitudinal strain (LAGLS(R)), and E/e’ was 59.7 versus 52.7 ml/m(2), 9.0% versus 18.9%, and 18.5 versus 14.0 in the acute inpatient setting, and 48.3 versus 38.2 ml/m(2), 12.8% versus 23.4%, and 16.9 versus 13.5 in the chronic outpatient setting when comparing HFrEF versus HFpEF, respectively. The relationship between LAVi and LAGLS(R) was significant in HFpEF, but not in HFrEF. Also, in those studies that directly compared patients with HFrEF versus HFpEF, those with HFrEF had worse LAGLS(R) [WMD = 16.3% (22.05,8.61); p < 0.001], and higher E/e’ [WMD = −0.40 (−0.56, −0.24); p < 0.05], while LAVi was comparable. When focusing on acute hospitalized patients, E/e’ was comparable between patients with HFrEF and HFpEF. Despite the higher burden of AF in HFpEF, patients with HFrEF had worse LA global function. Left atrial myopathy is not specifically related to HFpEF. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10741-021-10204-8. Springer US 2022-01-26 2022 /pmc/articles/PMC9388424/ /pubmed/35079942 http://dx.doi.org/10.1007/s10741-021-10204-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Jin, Xuanyi
Nauta, Jan F.
Hung, Chung-Lieh
Ouwerkerk, Wouter
Teng, Tiew-Hwa Katherine
Voors, Adriaan A.
Lam, Carolyn SP.
van Melle, Joost P.
Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title_full Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title_fullStr Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title_full_unstemmed Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title_short Left atrial structure and function in heart failure with reduced (HFrEF) versus preserved ejection fraction (HFpEF): systematic review and meta-analysis
title_sort left atrial structure and function in heart failure with reduced (hfref) versus preserved ejection fraction (hfpef): systematic review and meta-analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9388424/
https://www.ncbi.nlm.nih.gov/pubmed/35079942
http://dx.doi.org/10.1007/s10741-021-10204-8
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