Clinical implications of left atrial changes after optimization of medical therapy in patients with heart failure

Pagnesi, Matteo; Lombardi, Carlo; Anker, Stefan D.; Cleland, John G.F.; Dickstein, Kenneth; Filippatos, Gerasimos; Lang, Chim C.; Ng, Leong L.; Pellicori, Pierpaolo; Ponikowski, Piotr; Samani, Nilesh J.; Zannad, Faı̈ez; Veldhuisen, Dirk J. van; Solomon, Scott D.; Voors, Adriaan A.; Metra, Marco

doi:10.1002/ejhf.2593

Cited by 9 publications

(11 citation statements)

References 43 publications

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“…Up‐titration to higher doses of angiotensin‐converting enzyme inhibitors or angiotensin receptor blockers was independently associated with lower likelihood of LAAR. Furthermore, LAAR was independently associated with an increased risk of the composite of all‐cause mortality or HF hospitalization 18 …”

Section: Atrial Diseasementioning

confidence: 96%

“…Furthermore, LAAR was independently associated with an increased risk of the composite of all-cause mortality or HF hospitalization. 18 Cardiac amyloidosis may be difficult to diagnose. 19,20 Vergaro et al 21 highlighted the importance of atrial involvement ('atrial amyloidosis'), that might be a consequence of ventricular dysfunction, amyloid infiltration of the atrial wall or cardiotoxic damage following amyloid deposition.…”

Section: Treatmentmentioning

confidence: 99%

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November 2022 at a glance: focus on epidemiology, prognosis and comorbidities

Tomasoni

Adamo

Metra

2022

European J of Heart Fail

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The association between cardiometabolic health (CMH) and the risk of heart failure (HF) was assessed in a cohort of 5080 patients with type 2 diabetes (T2D) and without prevalent HF from the Look AHEAD trial. The CMH score included 2 points each for target levels of waist circumference, glomerular filtration rate (GFR), urine albumin-to-creatinine ratio, and 1 point each for blood pressure and glycated haemoglobin at target. Higher baseline CMH score and an improvement in CMH parameters were associated with a lower risk of incident HF. 1 Heart failure with preserved ejection fraction (HFpEF) accounts for more than half of HF hospitalizations. 2 Data regarding 41 708 patients hospitalized for HFpEF were collected between 2017 and 2021 across several centres in China. Patients were often burdened by multiple comorbidities, namely hypertension, atrial fibrillation and coronary artery disease (CAD). At 1-year follow-up, rehospitalization due to HF occurred in 13.6% of patients, while cardiovascular death in 3.1%. 3 The relationship between quality of care as assessed using the European Society of Cardiology (ESC) quality indicators (QIs) and outcome was investigated among 43 704 patients with HF from the Swedish HF registry. 4,5 Out of the 16 QIs, 13 could be measured and 5 were inversely associated with all-cause mortality during follow-up. Quality of care varied across the 80 centres included in the study. 5 BLITZ-HF was a nationwide initiative across 106 Italian centres evaluating the effectiveness of educational intervention to implement guideline-directed medical therapy (GDMT) in HF patients. Overall, 7218 HF patients, with both acute and chronic HF, were enrolled and a web-based pop-up system reminding GDMT recommendations was tested. At baseline, level of adherence to HF guidelines was already elevated. The use of the pop-up system led to a further improvement of six out of nine indicators. 6 Atrial diseaseAtrial function and dynamics play a key role in the development, progression and prognosis of HF. 16,17 Left atrial adverse remodelling (LAAR), defined as an increase in left atrial dimensions on

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Section: Atrial Diseasementioning

confidence: 96%

Section: Treatmentmentioning

confidence: 99%

November 2022 at a glance: focus on epidemiology, prognosis and comorbidities

Tomasoni

Adamo

Metra

2022

European J of Heart Fail

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“…We thank Yu et al for their comments on our research paper assessing the clinical and prognostic implications of left atrial (LA) structural changes after optimization of medical therapy in patients with heart failure (HF). 1 In the past decades, the concept of LA remodelling has evolved, and the contribution of the left atrium to the pathophysiology of HF has significantly grown. [2][3][4] Indeed, changes in LA structure and function may be either a marker of HF severity and a mechanism actively contributing to the progression of cardiac dysfunction.…”

Section: Reply To the Letter Regarding The Article 'Clinical Implicat...mentioning

confidence: 99%

Reply to the letter regarding the article ‘Clinical implications of left atrial changes after optimization of medical therapy in patients with heart failure’

Pagnesi

Lombardi

Solomon

et al. 2022

European J of Heart Fail

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“…Atrial myopathy underlies a structural and functional derangement associated with an increased risk of the development of atrial fibrillation 8–12 . It has been shown that measures of left atrial sphericity and left atrial volume indexed are independent predictors of atrial fibrillation recurrence after catheter ablation 13 .…”

mentioning

confidence: 99%

“…7 Editorial Atrial myopathy underlies a structural and functional derangement associated with an increased risk of the development of atrial fibrillation. [8][9][10][11][12] It has been shown that measures of left atrial sphericity and left atrial volume indexed are independent predictors of atrial fibrillation recurrence after catheter ablation. 13 Left atrial conduit, instead, depends on noninvasively assessed atrial stiffness and appears to be increased in heart failure patients with the worst survival.…”

mentioning

confidence: 99%