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December 8, 2020ESC Heart FailureOpen Access

Left Atrial Function and Maximal Exercise Capacity in Heart Failure with Preserved and Mid-Range Ejection Fraction

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Why the study?

Exercise intolerance is the leading manifestation of HFpEF or HFmrEF, and LA function might modulate LV filling and pulmonary venous pressures, but its association with maximal exercise capacity needed assessment.

Does impaired left atrial reservoir strain predict reduced maximal exercise capacity in patients with HFpEF or HFmrEF?

Comparison

Peak VO2 < 14 mL/kg/min vs peak VO2 ≥ 14 mL/kg/min

Design

Prospective registry-based observational study

Authors

CMCaterina MaffeisDMDaniel A. MorrisEBEvgeny Belyavskiy

Discussion

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Member takes

Overview

Supports LA reservoir strain for identifying low exercise capacity in HFpEF/HFmrEF; leaves open prospective validation before clinical use.

Structured PICO

Does impaired left atrial reservoir strain predict reduced maximal exercise capacity in patients with HFpEF or HFmrEF?

P
Population
65 patients with heart failure with preserved or mid-range ejection fraction (HFpEF or HFmrEF) prospectively enrolled in the German HFpEF Registry. Inclusion criteria: NYHA functional class ≥ II, LVEF > 40%, structural heart disease or diastolic dysfunction, and elevated levels of NT-proBNP.
I
Intervention
Left atrial (LA) function evaluation via speckle-tracking echocardiography (specifically LA reservoir strain)
C
Comparator
Patients with peak VO2 ≥ 14 mL/kg/min
O
Outcome
Maximal exercise capacity measured by peak VO2 (specifically peak VO2 < 14 mL/kg/min) during maximal cardiopulmonary exercise testsurrogate

In patients with HFpEF or HFmrEF, reduced left atrial reservoir strain is a strong independent predictor of severely impaired exercise capacity.

Cite This Study

Maffeis et al. (2020) studied this question.

synapsesocial.com/papers/6a090a7462c780efd627fd43https://doi.org/10.1002/ehf2.13143
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