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Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry

Few studies analyzed left atrial (LA) peak atrial longitudinal strain (PALS) determinants, particularly across heart failure (HF) stages. We aimed to analyze the pathophysiological and clinical PALS correlates in a large multicentric prospective study. This is a multicenter prospective observational...

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Autores principales: Benfari, Giovanni, Mandoli, Giulia Elena, Magne, Julien, Miglioranza, Marcelo Haertel, Ancona, Roberta, Luksic, Vlatka Reskovic, Pastore, Maria Concetta, Santoro, Ciro, Michalski, Blazej, Malagoli, Alessandro, Muraru, Denisa, Donal, Erwan, Cosyns, Bernard, Edvardsen, Thor, Popescu, Bogdan Alexandru, Cameli, Matteo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708811/
https://www.ncbi.nlm.nih.gov/pubmed/36445656
http://dx.doi.org/10.1007/s10554-022-02669-x
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author Benfari, Giovanni
Mandoli, Giulia Elena
Magne, Julien
Miglioranza, Marcelo Haertel
Ancona, Roberta
Luksic, Vlatka Reskovic
Pastore, Maria Concetta
Santoro, Ciro
Michalski, Blazej
Malagoli, Alessandro
Muraru, Denisa
Donal, Erwan
Cosyns, Bernard
Edvardsen, Thor
Popescu, Bogdan Alexandru
Cameli, Matteo
author_facet Benfari, Giovanni
Mandoli, Giulia Elena
Magne, Julien
Miglioranza, Marcelo Haertel
Ancona, Roberta
Luksic, Vlatka Reskovic
Pastore, Maria Concetta
Santoro, Ciro
Michalski, Blazej
Malagoli, Alessandro
Muraru, Denisa
Donal, Erwan
Cosyns, Bernard
Edvardsen, Thor
Popescu, Bogdan Alexandru
Cameli, Matteo
author_sort Benfari, Giovanni
collection PubMed
description Few studies analyzed left atrial (LA) peak atrial longitudinal strain (PALS) determinants, particularly across heart failure (HF) stages. We aimed to analyze the pathophysiological and clinical PALS correlates in a large multicentric prospective study. This is a multicenter prospective observational study enrolling 745 patients with HF stages. Data included PALS and left ventricular global longitudinal strain (LV-GLS). Exclusion criteria were: valvular prosthesis; atrial fibrillation; cardiac transplantation; poor acoustic window. Median global PALS was 17% [24–32]. 29% of patients were in HF-stage 0/A, 35% in stage-B, and 36% in stage-C. Together with age, the echocardiographic determinants of PALS were LA volume and LV-GLS (overall model R(2) = 0.50, p < 0.0001). LV-GLS had the strongest association with PALS at multivariable analysis (beta: −3.60 ± 0.20, p < 0.0001). Among HF stages, LV-GLS remained the most important PALS predictor (p < 0.0001) whereas age was only associated with PALS in lower HF-stage 0/A or B (R = − 0.26 p < 0.0001, R = − 0.23 p = 0.0001). LA volume increased its association to PALS moving from stage 0/A (R = − 0.11; P = 0.1) to C (R = − 0.42; P < 0.0001). PALS was the single most potent echocardiographic parameter in predicting the HF stage (AUC for B vs. 0/A 0.81, and AUC vs. 0/A for C 0.76). PALS remained independently associated with HF stages after adjusting for ejection fraction, E/e′ ratio, and mitral regurgitation grade (p < 0.0001). Although influenced by LV-GLS and LA size across HF stages, PALS is incrementally and independently associated with clinical status. LA function may reflect a substantial part of the hemodynamic consequences of ventricular dysfunction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-022-02669-x.
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spelling pubmed-97088112022-12-01 Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry Benfari, Giovanni Mandoli, Giulia Elena Magne, Julien Miglioranza, Marcelo Haertel Ancona, Roberta Luksic, Vlatka Reskovic Pastore, Maria Concetta Santoro, Ciro Michalski, Blazej Malagoli, Alessandro Muraru, Denisa Donal, Erwan Cosyns, Bernard Edvardsen, Thor Popescu, Bogdan Alexandru Cameli, Matteo Int J Cardiovasc Imaging Original Paper Few studies analyzed left atrial (LA) peak atrial longitudinal strain (PALS) determinants, particularly across heart failure (HF) stages. We aimed to analyze the pathophysiological and clinical PALS correlates in a large multicentric prospective study. This is a multicenter prospective observational study enrolling 745 patients with HF stages. Data included PALS and left ventricular global longitudinal strain (LV-GLS). Exclusion criteria were: valvular prosthesis; atrial fibrillation; cardiac transplantation; poor acoustic window. Median global PALS was 17% [24–32]. 29% of patients were in HF-stage 0/A, 35% in stage-B, and 36% in stage-C. Together with age, the echocardiographic determinants of PALS were LA volume and LV-GLS (overall model R(2) = 0.50, p < 0.0001). LV-GLS had the strongest association with PALS at multivariable analysis (beta: −3.60 ± 0.20, p < 0.0001). Among HF stages, LV-GLS remained the most important PALS predictor (p < 0.0001) whereas age was only associated with PALS in lower HF-stage 0/A or B (R = − 0.26 p < 0.0001, R = − 0.23 p = 0.0001). LA volume increased its association to PALS moving from stage 0/A (R = − 0.11; P = 0.1) to C (R = − 0.42; P < 0.0001). PALS was the single most potent echocardiographic parameter in predicting the HF stage (AUC for B vs. 0/A 0.81, and AUC vs. 0/A for C 0.76). PALS remained independently associated with HF stages after adjusting for ejection fraction, E/e′ ratio, and mitral regurgitation grade (p < 0.0001). Although influenced by LV-GLS and LA size across HF stages, PALS is incrementally and independently associated with clinical status. LA function may reflect a substantial part of the hemodynamic consequences of ventricular dysfunction. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10554-022-02669-x. Springer Netherlands 2022-07-01 2022 /pmc/articles/PMC9708811/ /pubmed/36445656 http://dx.doi.org/10.1007/s10554-022-02669-x 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 Original Paper
Benfari, Giovanni
Mandoli, Giulia Elena
Magne, Julien
Miglioranza, Marcelo Haertel
Ancona, Roberta
Luksic, Vlatka Reskovic
Pastore, Maria Concetta
Santoro, Ciro
Michalski, Blazej
Malagoli, Alessandro
Muraru, Denisa
Donal, Erwan
Cosyns, Bernard
Edvardsen, Thor
Popescu, Bogdan Alexandru
Cameli, Matteo
Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title_full Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title_fullStr Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title_full_unstemmed Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title_short Left atrial strain determinants and clinical features according to the heart failure stages. New insight from EACVI MASCOT registry
title_sort left atrial strain determinants and clinical features according to the heart failure stages. new insight from eacvi mascot registry
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9708811/
https://www.ncbi.nlm.nih.gov/pubmed/36445656
http://dx.doi.org/10.1007/s10554-022-02669-x
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