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April 1, 2022Circulation Cardiovascular Imaging

Left Atrial Reservoir Strain-Based Left Ventricular Diastolic Function Grading and Incident Heart Failure in Hypertrophic Cardiomyopathy

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Key result

Higher LARS-DD grade independently predicted hospitalization for heart failure or heart failure-related death in hypertrophic cardiomyopathy (HR 1.53 per 1-grade increase; 95% CI 1.03-2.28).

Why the study?

Echocardiographic assessment of LV diastolic dysfunction in hypertrophic cardiomyopathy is complex and not well-established, prompting investigation into whether left atrial reservoir strain can categorize dysfunction and predict heart failure events.

Does left atrial reservoir strain (LARS)-based grading predict hospitalization for heart failure or heart failure-related death in patients with hypertrophic cardiomyopathy?

Population

414 patients with hypertrophic cardiomyopathy

Comparison

LARS-defined LVDD grades (≥35%, ≥24% to <35%, ≥19% to <24%, and <19%)

Design

Cohort study

Follow-up

Median of 6.9 years

Discussion

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Member takes

Overview

LARS-DD grading may aid HF risk stratification in HCM; leaves open whether it improves outcomes over standard assessment in prospective studies.

Study Design

Type

Cohort (n=414)

Structured PICO

Does left atrial reservoir strain (LARS)-based grading predict hospitalization for heart failure or heart failure-related death in patients with hypertrophic cardiomyopathy?

P
Population
414 patients with hypertrophic cardiomyopathy (mean age 58.3 years, 34.3% female) followed for a median of 6.9 years.
E
Exposure
Left atrial reservoir strain (LARS)-defined left ventricular diastolic dysfunction (LARS-DD) grading
C
Comparator
Traditional echocardiographic LVDD parameters and grading system
O
Outcome
Composite of hospitalization for heart failure or heart failure-related death at median 6.9 years follow-upcomposite

Main Result

Hazard Ratio: 1.53 (95% CI 1.03–2.28)

p-value: p=<0.001

Left atrial reservoir strain provides a simple and independent prognostic index for predicting incident heart failure events in patients with hypertrophic cardiomyopathy, offering incremental value over traditional diastolic function grading.

Cite This Study

A 2022 study conducted a cohort in Hypertrophic cardiomyopathy (n=414). Left atrial reservoir strain-defined left ventricular diastolic dysfunction (LARS-DD) grade vs. Lower LARS-DD grade was evaluated on Hospitalization for heart failure or heart failure-related death (HR 1.53, 95% CI 1.03-2.28, p=<0.001). Higher LARS-DD grade independently predicted hospitalization for heart failure or heart failure-related death in hypertrophic cardiomyopathy (HR 1.53 per 1-grade increase; 95% CI 1.03-2.28).

synapsesocial.com/papers/6a995baf52d74751e82015e9https://doi.org/10.1161/circimaging.121.013556
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Also Consider

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

  1. 1Correlation of left atrial strain with left ventricular end-diastolic pressure in patients with normal left ventricular ejection fraction2020 · 73 citations
  2. 2Left Atrial Size and Function in Hypertrophic Cardiomyopathy Patients and Risk of New-Onset Atrial Fibrillation2017 · 192 citations
  3. 3Left Atrial Structure and Function, and Left Ventricular Diastolic Dysfunction2019 · 668 citations
  4. 4Correlation of Left Atrial Strain and Doppler Measurements with Invasive Measurement of Left Ventricular End‐Diastolic Pressure in Patients Stratified for Different Values of Ejection Fraction2015 · 249 citations
  5. 5Association of Left Atrial Function and Left Atrial Enhancement in Patients With Atrial Fibrillation2015 · 198 citations