Prediction of AF in Heart Failure With Preserved Ejection Fraction

Jasic-Szpak, E; Marwick, Thomas H.; Donal, Erwan; Przewlocka‐Kosmala, M.; Huynh, Quan; Goździk, Anna; Woznicka, Anna K; Jankowska, Ewa A.; Ponikowski, Piotr; Kosmala, Wojciech

doi:10.1016/j.jcmg.2020.07.040

Cited by 43 publications

(25 citation statements)

References 27 publications

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“…Recent data demonstrated an increasing role of LA strain as a prognostic cardiac imaging biomarker in the prediction of HFpEF and AF [11-15, 45, 46], which surpasses in accuracy, the traditional LA measurements of the atrial size [11][12][13][14][15]47]. Its promising prognostic role may result from the integration of combined information, not only about LA function alone, but also about the LV systolic and diastolic function.…”

Section: Discussionmentioning

confidence: 99%

“…Only recently, the LA longitudinal strain (change in length of the atrial walls during the cardiac cycle) emerged as a promising measure of the LA mechanical function [9,10]. Several studies suggested independent and superior to other morphological LA measures predictive role of the LA strain for the occurrence of paroxysmal AF in patients with ischemic stroke, hypertrophic cardiomyopathy, chemotherapy, HFpEF, and after coronary artery bypass grafting [11][12][13][14][15]. Moreover, LA strain was shown to independently predict incident HFpEF and to improve diastolic dysfunction classification [16][17][18][19].…”

Section: Key Pointsmentioning

confidence: 99%

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The Influence of Surgical Weight Reduction on Left Atrial Strain

et al. 2021

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Background Obesity increases and surgical weight reduction decreases the risk of atrial fibrillation (AF) and heart failure (HF). We hypothesized that surgically induced weight loss may favorably affect left atrial (LA) mechanical function measured by longitudinal strain, which has recently emerged as an independent imaging biomarker of increased AF and HF risk. Methods We retrospectively evaluated echocardiograms performed before and 12.2 ± 2.2 months after bariatric surgery in 65 patients with severe obesity (mean age 39 [36; 47] years, 72% of females) with no known cardiac disease or arrhythmia. The LA mechanical function was measured by the longitudinal strain using the semi-automatic speckle tracking method. Results After surgery, body mass index decreased from 43.72 ± 4.34 to 30.04 ± 4.33 kg/m2. We observed a significant improvement in all components of the LA strain. LA reservoir strain (LASR) and LA conduit strain (LASCD) significantly increased (35.7% vs 38.95%, p = 0.0005 and − 19.6% vs − 24.4%, p < 0.0001) and LA contraction strain (LASCT) significantly decreased (− 16% vs − 14%, p = 0.0075). There was a significant correlation between an increase in LASR and LASCD and the improvement in parameters of left ventricular diastolic and longitudinal systolic function (increase in E’ and MAPSE). Another significant correlation was identified between the decrease in LASCT and an improvement in LA function (decrease in A’). Conclusions The left atrial mechanical function improves after bariatric surgery. It is partially explained by the beneficial effect of weight reduction on the left ventricular diastolic and longitudinal systolic function. This effect may contribute to decreased risk of AF and HF after bariatric surgery. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Section: Key Pointsmentioning

confidence: 99%

The Influence of Surgical Weight Reduction on Left Atrial Strain

et al. 2021

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“…The noninvasive assessment of left atrium (LA) function by echocardiography is important in patients with atrial fibrillation (AF) qualified for ablation [1][2][3]. Left atrial strain (LAS) analysis by speckle tracking echocardiography (STE) is a relatively new method for evaluating LA function [4][5][6]. Some reports have highlighted the role of LAS in predicting the recurrence of AF after ablation [7] and a relationship between LAS values and invasively estimated left atrial pressure (LAP) values [8,9].…”

Section: Introductionmentioning

confidence: 99%

Correlations between left atrial strain and left atrial pressures values in patients undergoing atrial fibrillation ablation

et al. 2021

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Background:We aimed to investigate the correlations between left atrial strain (LAS) assessed by speckle tracking echocardiography and directly measured left atrial pressures (LAP) values and to estimate the features of patients with lower LAS values. Methods:A prospective, observational study was performed on patients with atrial fibrillation (AF) undergoing ablation. Detailed transthoracic echocardiography with the speckle tracking method was used to estimate the LAS reservoir (LASr) and direct measurements of LAP during ablation in all patients.Results: A total of 172 patients were included (98 with sinus rhythm [SR] and 74 with AF). The patients with lower LASr (first tercile) compared to those with higher (third tercile), were older, more often female, presented with a larger left atrium (LA) (per the LA area and volume index), and had more impaired left ventricular (LV) diastolic function parameters (e' , E/e'). The correlation analysis of the echocardiographic parameters with the LAP revealed the most significant correlations in the SR group, where the E/e' ratio, LASr, and LAS contraction (LASct) values were all associated with LAP. The cut-off value of LASr estimating high elevated mean LAP (≥15 mm Hg) was 21.88 (Area Under Curve [AUC], 0.81; 95% confidence interval [CI], 0.72-0.90; P <0.0001) for the SR group and 11.25 (AUC, 0.66; 95% CI, 0.53-0.80; P = 0.016) for the AF group.Conclusions: AF patients with lower LASr are older, more often female, have a larger LA, and have more impaired LV diastolic function. Low LASr and LASct and high E/e' ratio values are associated with higher LAP in AF patients with SR.

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“…Daher eignet sich die Messung zur frühen Detektion von diastolischen Funktionsstörungen oder LA-Fibrosierungen. Insbesondere bei Patienten mit klinischen Symptomen einer Herzinsuffizienz bei erhaltener LVEF eignet sich die LA-Reservoir-Funktion – auch nach Rekompensation der Patienten –, das Risiko von Vorhofflimmern und die Gesamtprognose abzuschätzen [ 44 , 47 ]. Bei Patienten mit Vorhofflimmern wird die Reservoir-Funktion des LA-Strains als bester echokardiographischer Surrogatparameter der LA-Fibrosierung beschrieben [ 20 ].…”

Section: Die Deformationsbildgebungunclassified

“…Da postoperativ bei erfolgreicher Operation einer hochgradigen MI die LVEF abnimmt, ist im Vergleich zum präoperativen Befund die Aufrechterhaltung des Vorwärtsschlagvolumens bzw. Herzzeitvolumens repräsentativ und prognostisch relevant [ 44 , 47 ]. Grundsätzlich umfasst die postoperative Echokardiographie nach Mitralklappenrekonstruktion bzw.…”

Section: Die Echokardiographie Bei Und Nach Kardiochirurgischen Operationenunclassified

Manual zur Indikation und Durchführung spezieller echokardiographischer Anwendungen

et al. 2021

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Das zweite Manual zur Indikation und Durchführung der Echokardiographie bezieht sich auf spezifische Anwendungen der Echokardiographie und besondere Fragestellungen bei speziellen Patientengruppen. Dabei stehen v. a. praktische Aspekte im Vordergrund. Methodisch etabliert sind die transösophageale Echokardiographie, die Stressechokardiographie und die Kontrastechokardiographie. Bei nahezu allen echokardiographischen Untersuchungen spielen aktuell 3‑D-Echokardiographie und Deformationsbildgebung eine Rolle. Das gesamte Spektrum der echokardiographischen Möglichkeiten wird derzeit in Notfall- und Intensivmedizin, bei der Überwachung und Führung von Katheterinterventionen, bei strukturellen Herzerkrankungen, bei herzchirurgischen Operationen, bei der Nachsorge von kardialen Unterstützungssystemen, bei kongenitalen Vitien im Erwachsenenalter und bei der Versorgung von hochinfektiösen Patienten in Pandemiezeiten angewandt. Die diagnostischen Fortschritte der konventionellen und modernen echokardiographischen Anwendungen stehen im Fokus dieses Manuals. Die 3‑D-Echokardiographie zur Charakterisierung der kardialen Morphologie und die Deformationsbildgebung zur Objektivierung der kardialen Funktion sind bei vielen Indikationen im klinischen Alltag etabliert. Die Stressechokardiographie zur Ischämie‑, Vitalitäts- und Vitiendiagnostik, die Bestimmung der koronaren Flussreserve und die Kontrastechokardiographie bei der linksventrikulären Wandbewegungsanalyse und kardialen Tumordetektion finden zunehmend klinische Anwendung. Wie für die konventionelle Echokardiographie im ersten Manual der Echokardiographie 2009 beschrieben, erfordert der Einsatz moderner echokardiographischer Verfahren die standardisierte Dokumentation und Akquisition bestimmter Bildsequenzen bei optimierter Geräteeinstellung, da korrekte und reproduzierbare Auswertungen nur bei guter Bildqualität möglich sind. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s12181-021-00509-1) enthält ein Abkürzungs‑, Tabellen‑, Abbildungsverzeichnis.

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Prediction of AF in Heart Failure With Preserved Ejection Fraction

Cited by 43 publications

References 27 publications

The Influence of Surgical Weight Reduction on Left Atrial Strain

The Influence of Surgical Weight Reduction on Left Atrial Strain

Correlations between left atrial strain and left atrial pressures values in patients undergoing atrial fibrillation ablation

Manual zur Indikation und Durchführung spezieller echokardiographischer Anwendungen

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