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January 30, 2012European Journal of Heart Failure

Atrial Dyssynchrony Syndrome: An Overlooked Phenomenon and a Potential Cause of ‘Diastolic’ Heart Failure

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Key result

Severe interatrial mechanical delay (>60 ms) was present in 59% of patients with HFPEF compared to 0% of age-matched controls.

Why the study?

Is interatrial dyssynchrony associated with heart failure with preserved ejection fraction (HFPEF)?

Population

7 patients with severe HFPEF for a case study, and 29 patients with HFPEF compared with 27 age-matched…

Comparison

Echocardiography, right heart catheterization… vs Age-matched control patients without HFPEF.

Design

Case-control

Authors

JEJean‐Christophe EicherGLGabriel LaurentAMAnaëlle Mathé

Discussion

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Overview

Interatrial dyssynchrony may contribute to HFpEF; hypothesis-generating for atrial resynchronization trials.

Study Design

Type

Case-Control (n=63)

Structured PICO

Is interatrial dyssynchrony associated with heart failure with preserved ejection fraction (HFPEF)?

P
Population
63 participants, comprising 7 severe HFPEF patients in a case study and 29 HFPEF patients compared with 27 age-matched controls in a pilot study.
E
Exposure
Echocardiography, right heart catheterization, electrophysiological study (EPS), and left atrial pacing (in the case study).
C
Comparator
Age-matched control patients without HFPEF (for the pilot study).
O
Outcome
Interatrial mechanical delays (IAMD) and interatrial conduction delay (IACD).surrogate

Main Result

Absolute Event Rate: 59% vs 0%

Interatrial dyssynchrony is highly prevalent in HFPEF, leading to delayed left atrial systole and increased filling pressures, and represents a potential therapeutic target for atrial resynchronization.

Cite This Study

Eicher et al. (2012) conducted a case-control in Heart failure with preserved ejection fraction (HFPEF) (n=63). Heart failure with preserved ejection fraction (HFPEF) vs. Age-matched controls was evaluated on Prevalence of severe interatrial mechanical delay (IAMD) >60 ms. Severe interatrial mechanical delay (>60 ms) was present in 59% of patients with HFPEF compared to 0% of age-matched controls.

synapsesocial.com/papers/6a2011e1c705fa157d0db002https://doi.org/10.1093/eurjhf/hfr169
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Impaired Chronotropic and Vasodilator Reserves Limit Exercise Capacity in Patients With Heart Failure and a Preserved Ejection Fraction2006 · 701 citations
  2. 2How to diagnose diastolic heart failure: a consensus statement on the diagnosis of heart failure with normal left ventricular ejection fraction by the Heart Failure and Echocardiography Associations of the European Society of Cardiology2007 · 2,689 citations
  3. 3Prolonged atrial conduction. A major predisposing factor for the development of atrial flutter.1978 · 189 citations
  4. 4Implementation of Device Therapy (Cardiac Resynchronization Therapy and Implantable Cardioverter Defibrillator) for Patients with Heart Failure in Europe: Changes from 2004 to 20082009 · 134 citations
  5. 5Recommendations regarding quantitation in M-mode echocardiography: results of a survey of echocardiographic measurements.1978 · 7,474 citations