Prognostic Relevance of Left Atrial Dysfunction in Heart Failure With Preserved Ejection Fraction
Why the study?
Does left atrial dysfunction (lower peak LA strain) predict adverse cardiovascular outcomes in patients with HFpEF?
Population
357 patients with heart failure with preserved ejection fraction who were in sinus rhythm at the time of…
Design
Cohort
Follow-up
mean 31 months (interquartile range, 18-43 months)
Key result
Lower peak LA strain was associated with a higher risk of cardiovascular death, HF hospitalization, and aborted sudden death (HR 0.96 per unit reduction; 95% CI 0.94-0.99; P=0.009).
Authors
Discussion
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Member takes
Overview
LA strain may enhance HFpEF risk stratification beyond LA size; leaves open whether it should guide therapy.
Study Design
Type
Cohort (n=357)
Structured PICO
Does left atrial dysfunction (lower peak LA strain) predict adverse cardiovascular outcomes in patients with HFpEF?
P
Population
357 patients with heart failure with preserved ejection fraction in sinus rhythm, followed for a mean of 31 months.
E
Exposure
Assessment of left atrial (LA) function (peak LA strain) measured by speckle-tracking echocardiography
O
Outcome
Composite end point of cardiovascular death, heart failure hospitalization, and aborted sudden deathcomposite
Main Result
Hazard Ratio: 0.96 (95% CI 0.94–0.99)
p-value: p=0.009
Left atrial dysfunction in HFpEF is associated with adverse outcomes, but this prognostic risk is largely explained by concurrent impairments in left ventricular systolic and diastolic function.
Cite This Study
Santos et al. (2016) conducted a cohort in Heart failure with preserved ejection fraction (HFpEF) (n=357). Lower peak LA strain vs. Higher peak LA strain was evaluated on Composite end point of cardiovascular death, HF hospitalization, and aborted sudden death (HR 0.96, 95% CI 0.94-0.99, p=0.009). Lower peak LA strain was associated with a higher risk of cardiovascular death, HF hospitalization, and aborted sudden death (HR 0.96 per unit reduction; 95% CI 0.94-0.99; P=0.009).