Correlation with invasive left ventricular filling pressures and prognostic relevance of the echocardiographic diastolic parameters used in the 2016 ESC heart failure guidelines and in the 2016 ASE/EACVI recommendations: a systematic review in patients with heart failure with preserved ejection fraction

Nauta, Joske; Hummel, Yoran M.; Meer, Peter van der; Lam, Carolyn S.P.; Voors, Adriaan A.; Melle, Joost P. van

doi:10.1002/ejhf.1220

Cited by 159 publications

(140 citation statements)

References 45 publications

Supporting

Mentioning

133

Contrasting

Unclassified

Order By: Relevance

“…However, given the paucity of available studies, the incremental value of LA functional indices in discrimination of HFpEF diagnosis or prognosis above and beyond existing risk stratification models comprising clinical characteristics and/or other echocardiographic data has not yet been studied, and should be the focus of future research. Recent studies have also shown echocardiographic measures of LV diastolic function to be correlated to invasive haemodynamic measures and outcomes in HFpEF . Similar studies assessing the correlation of echocardiographic LA functional parameters with invasively measured parameters could provide additional insights and should be undertaken.…”

Section: Discussionmentioning

confidence: 86%

“…Recent studies have also shown echocardiographic measures of LV diastolic function to be correlated to invasive haemodynamic measures and outcomes in HFpEF. 39,40 Similar studies assessing the correlation of echocardiographic LA functional parameters with invasively measured parameters could provide additional insights and should be undertaken.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Khan

Memon

Murad

et al. 2020

European J of Heart Fail

Self Cite

View full text Add to dashboard Cite

Aims Left atrial (LA) mechanical function may play a significant role in the development and progression of heart failure with preserved ejection fraction (HFpEF). We performed a systematic review and meta‐analysis to evaluate association of impaired LA function with outcomes in HFpEF. Methods and results Multiple databases were searched for original studies measuring different phases of LA function in HFpEF patients. Comparative LA function between HFpEF patients and healthy controls was assessed by pooling weighted mean differences (WMD). Adjusted hazard ratios (HRs) with 95% confidence intervals were pooled to evaluate the prognostic utility of LA function. Twenty‐two studies (2 trials, 20 observational) comprising 1974 HFpEF patients and 751 healthy controls were included. HFpEF patients had decreased LA reservoir [WMD = −12.21% (−15.47, −8.95); P < 0.001], LA conduit [WMD = −5.68% (−8.56, −2.79); P < 0.001], and pump [WMD = −11.07% (−14.81, −7.34); P < 0.001] emptying fractions compared with controls. LA reservoir [WMD = −13.38% (−16.07, −10.68); P < 0.001], conduit [WMD = −4.09% (−6.77, −1.42); P = 0.003], and pump [WMD = −3.53% (−4.47, −2.59); P < 0.001] strains were also significantly lower in HFpEF patients. Decreased LA reservoir strain [HR 1.24 (1.02, 1.50); P = 0.03] was significantly associated with risk of composite all‐cause mortality or heart failure hospitalization. Conclusions Impaired LA function appears to have diagnostic and prognostic value in HFpEF, but whether indices of LA function truly refine discrimination for diagnosis or prognosis remains to be fully determined. Larger studies are needed to better evaluate associations between LA function and clinical outcomes and the role of LA function as a target for novel HFpEF therapies.

show abstract

Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Khan

Memon

Murad

et al. 2020

European J of Heart Fail

Self Cite

View full text Add to dashboard Cite

show abstract

“…SOBOTA‐HF study will, with comprehensive transthoracic echocardiography and external independent core echocardiography laboratory centre, be able to investigate the prevalence of three HF phenotypes per LVEF. For the purposes of the primary endpoint, we will apply the ESC guidelines criteria; nonetheless, we will also adopt other criteria for diagnosis of diastolic dysfunction, which will allow the comparison of different approaches, also in conjunction with different natriuretic peptide cut‐offs to suggest the optimal practice to be adopted in daily routine …”

Section: Discussionmentioning

confidence: 99%

Heart failure prevalence in the general population: SOBOTA‐HF study rationale and design

et al. 2019

View full text Add to dashboard Cite

Aims Epidemiological heart failure (HF) data in the era of natriuretic peptides and echocardiography are scarce. The primary aim of this study is to evaluate the HF prevalence in the general population. We will also investigate natriuretic peptide cut-off for diagnosis of HF. Finally, we will be able to identify left ventricular function phenotypes and study relations between cardiac function, clinical presentation, and health-related quality of life. Methods and resultsScreening Of adult urBan pOpulation To diAgnose Heart Failure (SOBOTA-HF) is a cross-sectional prevalence study in a representative sample of Murska Sobota residents aged 55 years or more. Individuals will be invited to attend screening visit with point-of-care N-terminal pro-b-type natriuretic peptide (NT-proBNP) testing. All subjects with NT-proBNP ≥ 125 pg/mL will be invited for a diagnostic visit that will include history and physical examination, electrocardiogram, echocardiography, blood and urine sampling, ankle brachial index, pulmonary function tests, body composition measurement, physical performance tests, and questionnaires. To validate the screening procedure, a control group (NT-proBNP < 125 pg/mL) will undergo the same diagnostic evaluation. An external centre will validate echocardiography results, and the HF diagnosis will be adjudicated within an international HF expert panel. Overall and age-specific HF prevalence will be calculated in individuals ≥ 55 years and extrapolated to the whole population. Conclusions The SOBOTA-HF study will test the latest HF guideline diagnostic criteria in the general population sample. Next to HF prevalence, it will provide insight into left ventricular function and general patient phenotype; we will also extend current understanding of natriuretic peptides for HF screening.

show abstract

“…We studied 143 consecutive patients with clinical and echocardiographic signs of HF (NYHA class 1‐III) diastolic dysfunction and LV EF (≥45%), according to 2016 ESC Heart Failure Guidelines . Forty‐one healthy gender‐ and age‐matched subjects served as controls.…”

Section: Methodsmentioning

confidence: 99%

“…We studied 143 consecutive patients with clinical and echocardiographic signs of HF (NYHA class 1-III) diastolic dysfunction and LV EF (≥45%), according to 2016 ESC Heart Failure Guidelines. 26 Forty-one healthy gender-and age-matched subjects served as controls. Patients were divided into those with (n = 40) or without RV (n = 103) dysfunction according to the echocardiographic parameters previously used.…”

Section: Study Populationmentioning

confidence: 99%

Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction

et al. 2019

View full text Add to dashboard Cite

Background and Aim Predictors of exercise capacity in heart failure (HF) with preserved ejection fraction (HFpEF) remain of difficult determination. The aim of this study was to identify predictors of exercise capacity in a group of patients with HFpEF and right ventricle (RV) dysfunction Methods In 143 consecutive patients with HFpEF (age 62 ± 9 years, LV EF ≥45) and 41 controls, a complete echocardiographic study was performed. In addition to conventional measurements, LA compliance was calculated using the formula: [LAV max − LAV min/LAV min × 100]. Exercise capacity was assessed using the six‐minute walking test (6‐MWT). Tricuspid annular plane systolic excursion (TAPSE) < 1.7 cm was utilized to categorize patients with RV dysfunction (n = 40) from those with maintained RV function (n = 103). Results Patients with RV dysfunction were older (P = 0.002), had higher NYHA class (P = 0.001), higher LV mass index (P = 0.01), reduced septal and lateral MAPSE (all P < 0.001), enlarged LA (P = 0.001) impaired LA compliance index (P < 0.001) and exhibited a more compromised 6‐MWT (P = 0.001). LA compliance index correlated more closely with 6‐MWT (r = 0.51, P < 0.001) compared with the other LA indices (AP diameter, transverse diameter and volume indexed; r = −0.30, r = −0.35 and r = −0.38, respectively). In multivariate analysis, LA compliance index <60% was 88% sensitive and 61% specific (AUC 0.80, CI = 0.67–0.92 P = 0.001) in predicting exercise capacity. Conclusion An impairment in LA compliance was profound in patients with HFpEF and RV dysfunction and seems to be most powerful independent predictor of limited exercise capacity.

show abstract

Abstract: Only a small number of studies validated the use of echocardiographic parameters at rest in patients with HFpEF. The best established parameter appears to be E/e', but the existing data only show modest correlations of E/e' with invasive filling pressures and outcomes in HFpEF.

Cited by 159 publications

References 45 publications

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Left atrial function in heart failure with preserved ejection fraction: a systematic review and meta‐analysis

Heart failure prevalence in the general population: SOBOTA‐HF study rationale and design

Left atrial compliance index predicts exercise capacity in patients with heart failure and preserved ejection fraction irrespective of right ventricular dysfunction

Contact Info

Product

Resources

About