Impact of Increased Right Atrial Size on Long-Term Mortality in Patients With Heart Failure Receiving Cardiac Resynchronization Therapy

Altes, Alexandre; Appert, Ludovic; Delelis, François; Guyomar, Yves; Menet, Aymeric; Ennezat, Pierre‐Vladimir; Guerbaaï, Raphaëlle-Ashley; Graux, P; Tribouilloy, Christophe; Maréchaux, Sylvestre

doi:10.1016/j.amjcard.2018.12.015

Cited by 6 publications

(4 citation statements)

References 21 publications

(19 reference statements)

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“…In patients with chronic HFrEF, RAVI is a determinant of right‐sided systolic dysfunction (Sallach et al, 2009 ) and it provides independent risk prediction of long‐term adverse events (Darahim, 2014 ). RA enlargement is also a powerful and reproducible independent predictor of long‐term mortality in patients with HFrEF in sinus rhythm receiving cardiac resynchronization therapy (Altes et al, 2019 ).…”

Section: Discussionmentioning

confidence: 99%

Predictors of right ventricular function improvement with sacubitril/valsartan in a real‐life population of patients with chronic heart failure

Correale

Mazzeo

Magnesa

et al. 2021

Clin Physio Funct Imaging

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Background Observational studies have demonstrated that treatment with sacubitril/valsartan may improve left ventricular (LV) systolic and diastolic function in subjects with reduced LV ejection fraction (LVEF) in real‐world studies. Subjects with heart failure and reduced EF (HFrEF), however, are also characterized by an impaired right ventricular (RV) function. We therefore aimed to evaluate whether also RV function may improve after S/V therapy and possible predictors of RV improvement could be identified at echocardiography and tissue Doppler imaging. Methods Fifty consecutive patients (67 ± 8 years, LVEF 28 ± 6%, male 86%) with chronic HFrEF and NYHA class II‐III were followed up for 6 months after therapy with S/V. LV&RV function was assessed at baseline and after 6 months of therapy. Results After 6‐month therapy with S/V a significant improvement was shown in the following echocardiography parameters assessing RV function: PAsP (31 ± 11 vs. 35 ± 10 mmHg, p < 0.001), TAPSE (19 ± 3 vs. 18 ± 3 mm, p < 0.001), RV FAC (38 ± 7 vs. 34 ± 6 mm, p < 0.001), RV S’ (12 ± 2 vs. 10 ± 2 cm/s, p < 0.001), RV‐FW‐LS (−20 ± 5 vs. −18 ± 5%, p < 0.001), RV‐4Ch‐LS (−16 ± 5 vs. −14 ± 5%, p < 0.001). At multivariable analysis improvement in RV‐FW‐LS was associated to baseline levels of RV S’ (r 0.75, p < 0.01) and RAV (r –0.32, p < 0.05). Conclusions In a real‐world scenario, 6‐month therapy with S/V was associated with an improved RV function in HFrEF. RV function improvement may be predicted by assessing baseline RV S’ and right atrial volume values.

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Section: Discussionmentioning

confidence: 99%

Predictors of right ventricular function improvement with sacubitril/valsartan in a real‐life population of patients with chronic heart failure

Correale

Mazzeo

Magnesa

et al. 2021

Clin Physio Funct Imaging

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“…They concluded that RAVI measured by CMR imaging is an independent predictor of mortality in patients with heart failure with reduced ejection fraction [21]. Alexandre Altes et al examined the relation between RAVI and long term mortality of patient with systolic HF who received cardiac resynchronization therapy, they included 172 patients and they found that for every 1 mL/m2 increase in RAVI the risk of death was increasing p ¼ (0.042) and patients in the highest tertile (RAVI >29 mL/m2) had significantly higher risk of death compared with those with RAVI 29 mL/m 2 p ¼ (0.014) [22]. The RAVI value in the last 2 studies which predict poor outcome is close to our finding that RAVI30 ml/m 2 predicts persistent RV dysfunction after acute IWMI due to proximal RCA occlusion.…”

Section: Discussionmentioning

confidence: 99%

Right Atrial Volume Index as a Predictor of Persistent Right Ventricular Dysfunction in Patients with Acute Inferior Myocardial Infarction and Proximal Right Coronary Artery Occlusion Treated with Primary Percutaneous Coronary Intervention

Naseem¹,

Samir²

2021

Journal of the Saudi Heart Association

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Objectives Patients with right ventricular (RV) infarctions associated with inferior infarctions have higher rates of adverse events than isolated inferior infarctions. Right atrial volume index (RAVI) has recently been described as a predictor of clinical outcome in patients with chronic systolic heart failure and pulmonary hypertension. The aim of this study is to assess the ability of RAVI to predict the persistent RV dysfunction after acute inferior STEMI due to occlusion of proximal RCA. To the best of our knowledge, this is the first study to investigate the relation between RAVI and persistent RV dysfunction in such group of patients. Patients and methods Sixty-five consecutive patients with recent first acute inferior STEMI who underwent primary percutaneous coronary intervention (PPCI) were prospectively included in the study. Echocardiographic evaluation was performed at the time of discharge and at 3 months. All the patients underwent standard echocardiographic assessment using conventional 2D and tissue Doppler imaging (TDI). Results Patients were divided into two groups according to right ventricular function (RVF) 3 months after acute myocardial infarction (AMI). The normal RVF group included 41 (63%) patients and the impaired RVF group included 24 (37%) patients. RAVI was significantly higher in patients with impaired RVF (p=<0.001). RAVI was a predictor of persistently impaired RV function (odds ratio = 1.786, 95% confidence interval, 1.367–2.335, p value= <0.001) and (odds ratio = 1.829, 95% confidence interval, 1.358–2.462, p value= <0.001) in univariate and multivariable logistic regression analyses respectively. In receiving operator characteristics (ROC) curve analysis, RAVI with a cutoff value ≥ 30 ml/m 2 had a 87.5% sensitivity, a 92.24% specificity area under Receiving operator characteristics (ROC) curve = 0.964 for predicting persistently impaired RVF. Conclusion In patients with inferior STEMI with proximal RCA occlusion, RAVI is an independent predictor of persistently impaired RVF with a cut-off value ≥ 30 ml/m 2 .

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“…A maximális JP-i volumen, illetve testfelszínre indexált ben írták le. HFrEF-betegekben a JPVI összefüggést mutatott a betegek funkcionális állapotával, valamint a mortalitás és egyéb adverz események független prediktorának bizonyult (26)(27)(28)(29)(30). Hasonló eredmények születtek PAH-populációban is (31,32).…”

Section: A Jobb Pitvar Méretének Klinikai Jelentőségeunclassified

A jobb pitvari méret és funkció noninvazív vizsgálatának módszerei és jelentőségük

Nógrádi¹,

Faludi²

2020

Cardiologia Hungarica

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A szív képalkotó vizsgálatai hagyományosan a bal kamrára összpontosítottak, majd az utóbbi évtizedekben a bal pit-gálható a szívüregek közül utolsóként a jobb pitvar is. A pitvarméretek egy-majd kétdimenziós vizsgálata után ma már tak. A jobb pitvari morfológia és funkció részleteinek megismerése új adatokkal gazdagíthatja a diagnosztikát, valamint a rizikó és a prognózis becslését.The traditional target of the cardiovascular imaging was the left ventricle. In the last decades the left atrium and the right heart also gained importance. The development of new imaging modalities such as modern echocardiographic techniques, cardiac CT and MRI made it possible to acquire more exact and detailed knowledge of the right atrium, as the last cardiac chamber to be investigated. After the one-and two-dimensional evaluation of the right atrial size, assessment of the phases of right atrial function, providing more information on early functional impairment and compensatory mechanisms. The detailed knowledge of right atrial morphology and function allows for more exact diagnosis, risk assessment and prognostic evaluation. BevezetésRégen elmúlt már az a korszak, amikor a jobb szívfél ben. Napjainkban a jobb kamra (1, 2) mellett a jobb rek -modern echokardiográfiás technikák, CT, MRsegítségével egyre több diagnosztikus és prognosztiis.-ták, és ezek az adatok nagymértékben hozzájárultak a balszívfél-elégtelenség patofiziológiájának megértésépárhuzamosan egyre több adat áll rendelkezésre a JP-i mechanikával kapcsolatban is, amelyek figyelmet érdemelnek. Így jelen munkánk célja, hogy áttekintsük a JP-i méret-és funkció vizsgálatára szolgáló noninvazív kép-

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Impact of Increased Right Atrial Size on Long-Term Mortality in Patients With Heart Failure Receiving Cardiac Resynchronization Therapy

Cited by 6 publications

References 21 publications

Predictors of right ventricular function improvement with sacubitril/valsartan in a real‐life population of patients with chronic heart failure

Predictors of right ventricular function improvement with sacubitril/valsartan in a real‐life population of patients with chronic heart failure

Right Atrial Volume Index as a Predictor of Persistent Right Ventricular Dysfunction in Patients with Acute Inferior Myocardial Infarction and Proximal Right Coronary Artery Occlusion Treated with Primary Percutaneous Coronary Intervention

A jobb pitvari méret és funkció noninvazív vizsgálatának módszerei és jelentőségük

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