Left atrial diameter in heart failure with left ventricular preserved, mid-range, and reduced ejection fraction

Zhu, Ning; Chen, Hao; Zhao, Xuyong; Ye, Fanhao; Jiang, Wenbing; Wang, Yichuan

doi:10.1097/md.0000000000018146

Cited by 18 publications

(16 citation statements)

References 30 publications

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“…Most human HFrEF RNA-Seq studies were focused on regional changes within the LV. HFrEF-related gene expression changes in other heart chambers have not been thoroughly explored, despite the known clinical link between the left atrium (LA) and HFrEF prognosis 19 , 20 . Recent advances and application of single cell technology in cardiac tissues have revealed cellular expression network heterogeneity and led to novel insights of cardiac physiology and pathology 11 – 13 , 21 .…”

Section: Introductionmentioning

confidence: 99%

Chamber-enriched gene expression profiles in failing human hearts with reduced ejection fraction

Luo

Yin

Dwyer

et al. 2021

Sci Rep

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Heart failure with reduced ejection fraction (HFrEF) constitutes 50% of HF hospitalizations and is characterized by high rates of mortality. To explore the underlying mechanisms of HFrEF etiology and progression, we studied the molecular and cellular differences in four chambers of non-failing (NF, n = 10) and HFrEF (n = 12) human hearts. We identified 333 genes enriched within NF heart subregions and often associated with cardiovascular disease GWAS variants. Expression analysis of HFrEF tissues revealed extensive disease-associated transcriptional and signaling alterations in left atrium (LA) and left ventricle (LV). Common left heart HFrEF pathologies included mitochondrial dysfunction, cardiac hypertrophy and fibrosis. Oxidative stress and cardiac necrosis pathways were prominent within LV, whereas TGF-beta signaling was evident within LA. Cell type composition was estimated by deconvolution and revealed that HFrEF samples had smaller percentage of cardiomyocytes within the left heart, higher representation of fibroblasts within LA and perivascular cells within the left heart relative to NF samples. We identified essential modules associated with HFrEF pathology and linked transcriptome discoveries with human genetics findings. This study contributes to a growing body of knowledge describing chamber-specific transcriptomics and revealed genes and pathways that are associated with heart failure pathophysiology, which may aid in therapeutic target discovery.

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Section: Introductionmentioning

confidence: 99%

Chamber-enriched gene expression profiles in failing human hearts with reduced ejection fraction

Luo

Yin

Dwyer

et al. 2021

Sci Rep

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show abstract

“…In the multivariate regression analysis, one of the independent predictors of fQRS was the LAD. Atrial dilatation, which is a sign of left atrial remodeling and diastolic dysfunction, has been shown to be associated with many cardiovascular diseases such as atrial fibrillation and heart failure [39,40]. Therefore, those with fQRS may have greater myocardial dysfunction, and these patients should be followed more closely to prevent the development of advanced acromeglic cardiomyopathy.…”

Section: Discussionmentioning

confidence: 99%

Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients

et al. 2021

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Background/aim: It is known that the presence of fragmented QRS (fQRS) on electrocardiography (ECG) is associated with cardiovascular events. The aim of this study was the evaluation of fQRS formation and its relationship with the left ventricular hypertrophy (LVH) parameters in acromegaly patients. Materials and methods:In total, 47 previously diagnosed with non-hypertensive acromegaly patients and 48 control subjects were included in the study. ECG and transthoracic echocardiography (TTE) were performed for each participant. Acromegaly patients were divided into two groups according to the fQRS formation on the ECG. Left ventricular wall thicknesses, and left atrial diameter (LAD), left ventricular mass (LVM), left ventricular mass index (LVMi), and relative wall thickness (RWT) were obtained. Results:In control group 5 (10.4%) and in acromegaly group 17 (36.2%) patients had fQRS on ECG (p = 0.003).

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“…[1] and Eq. [2] (see above) into software, input t1-t2, t1-t3, which could automatically calculate LAP ECHO . LAP ECHO was calculated for 3 consecutive cardiac cycles, and the average value was selected for the statistical analysis.…”

Section: Lap Echo Calculationmentioning

confidence: 99%

“…Currently, a variety of non-invasive methods for evaluating LAP, such as the "Doppler + sphygmomanometer" method have been explored. Due to their inaccuracy and complexity, these methods have not been used in clinical practice (2,3).…”

Section: Introductionmentioning

confidence: 99%

Experimental study: using the continuous wave Doppler spectrum technique to detect left atrial pressure

Zheng¹,

Jin²,

Fu³

et al. 2022

Ann Transl Med

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Background: This study sought to investigate the accuracy of estimating left atrial pressure (LAP) using the continuous wave Doppler spectrum of mitral regurgitation.Methods: Dog models of left atrial hypertension with mitral regurgitation were established with disposable biopsy forceps and the injection of melamine formaldehyde resin microsphere suspension. A total of 40 models of left atrial hypertension with different hemodynamic statuses were established by injecting either esmolol or dobutamine in which the spectrums of mitral regurgitation were clear and the regurgitation velocity exceeded 3.5 m/s. The continuous wave Doppler spectrums of mitral regurgitation were recorded and analyzed to estimate left atrial pressure (LAP ECHO ). The mean left atrial pressure (LAP C-MEAN ), the isovolumic diastolic left atrial pressure (LAP C-IVRT ), the maximum left atrial pressure (LAP C-MAX ), and the minimum left atrial pressure (LAP C-MIN ) were also measured using the catheter method in the same cardiac cycle. Results:The LAP ECHO (mean ± standard deviation; 11.77±4.36 mmHg) was correlated with the LAP C-MEAN (11.51±4.77 mmHg; r=0.887, P=0.000), but the difference was not statistically significant (P=0.459). The LAP ECHO was correlated with the LAP C-IVRT (12.16±4.72 mmHg; r=0.883, P=0.000), but the difference was not statistically significant (P=0.271). There was a correlation between the LAP C-MEAN and the LAP C-IVRT (r=0.987, P=0.000), and the difference was statistically significant (P=0.000).Conclusions: This study suggests that the ultrasound evaluation of LAP correlates well with LAP measured using the gold standard catheter method, and is a simple, convenient, non-invasive method to quantitatively estimate LAP. This method is promising, but further large-scale animal experiments and clinical studies need to be conducted.

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Left atrial diameter in heart failure with left ventricular preserved, mid-range, and reduced ejection fraction

Cited by 18 publications

References 30 publications

Chamber-enriched gene expression profiles in failing human hearts with reduced ejection fraction

Chamber-enriched gene expression profiles in failing human hearts with reduced ejection fraction

Assessment of fragmented QRS formation and its relationship with left ventricular hypertrophy in nonhypertensive acromegaly patients

Experimental study: using the continuous wave Doppler spectrum technique to detect left atrial pressure

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