What is the clinical evidence from this study?

Study design: Cohort. Population: Heart failure (n=174). Intervention: Left atrial reservoir strain (LASr) vs. NT-proBNP. Primary outcome: Composite of all-cause mortality or hospitalization for heart failure (AUC 0.79).

March 14, 2022Open Access

Left atrial reservoir strain as a predictor of cardiac outcome in patients with heart failure: the HaFaC cohort study

Key Result

Left atrial reservoir strain strongly predicted the composite endpoint of heart failure hospitalization and all-cause mortality with an AUC of 0.79, showing comparable specificity to NT-proBNP.

Study Design

Type

Cohort (n=174)

Multicenter

Structured PICO

Does left atrial reservoir strain (LASr) predict heart failure hospitalization and all-cause mortality in outpatients with heart failure?

Population

174 outpatients with heart failure (43% reduced, 36% mildly reduced, and 21% preserved ejection fraction)

Intervention

Left atrial reservoir strain (LASr) measurement via speckle tracking echocardiography

Comparator

NT-proBNP measurement

Outcome

Composite endpoint of HF hospitalization and all-cause mortality within 1 yearcomposite

Left atrial reservoir strain is strongly inversely correlated with NT-proBNP and serves as a useful echocardiographic predictor for 1-year HF hospitalization and all-cause mortality in heart failure outpatients.

Main Result

Effect estimate: AUC 0.79

Limitations

Subgroups of different HF types were relatively small
Number of events was too small to perform a multivariate Cox regression analysis
Length of follow-up was limited to 1 year
Exact cause of death was not known in all HF patients
LASr could not be analyzed in 7% of the study population due to poor image quality

Abstract

Abstract Background The left atrium (LA) is a key player in the pathophysiology of systolic and diastolic heart failure (HF). Speckle tracking derived LA reservoir strain (LAS r ) can be used as a prognostic surrogate for elevated left ventricular filling pressure similar to NT-proBNP. The aim of the study is to investigate the correlation between LAS r and NT-proBNP and its prognostic value with regards to the composite endpoint of HF hospitalization and all-cause mortality within 1 year. Methods Outpatients, sent to the echocardiography core lab because of HF, were enrolled into this study. Patients underwent a transthoracic echocardiographic examination, commercially available software was used to measure LAS r . Blood samples were collected directly after the echocardiographic examination to determine NT-proBNP. Results We included 174 HF patients, 43% with reduced, 36% with mildly reduced, and 21% with preserved ejection fraction. The study population showed a strong inverse correlation between LAS r and log-transformed NT-proBNP (r = − 0.75, p < 0.01). Compared to NT-proBNP, LAS r predicts the endpoint with a comparable specificity (83% vs. 84%), however with a lower sensitivity (70% vs. 61%). Conclusion LAS r is inversely correlated with NT-proBNP and a good echocardiographic predictor for the composite endpoint of hospitalization and all-cause mortality in patients with HF. Trial registration : https://www.trialregister.nl/trial/7268

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Cite This Study

Bouwmeester et al. (Mon,) conducted a cohort in Heart failure (n=174). Left atrial reservoir strain (LASr) vs. NT-proBNP was evaluated on Composite of all-cause mortality or hospitalization for heart failure (AUC 0.79). Left atrial reservoir strain strongly predicted the composite endpoint of heart failure hospitalization and all-cause mortality with an AUC of 0.79, showing comparable specificity to NT-proBNP.

synapsesocial.com/papers/6a1bfcf9d54006be995f5ae8 https://doi.org/https://doi.org/10.1186/s12872-022-02545-5

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