Left Atrial Systolic and Diastolic Dysfunction in Heart Failure with Normal Left Ventricular Ejection Fraction

Morris, Daniel A.; Gailani, Mudather; Pérez, Amalia Vaz; Blaschke, Florian; Dietz, Rainer; Haverkamp, Wilhelm; Özcelik, Cemil

doi:10.1016/j.echo.2011.02.004

Cited by 125 publications

(114 citation statements)

References 70 publications

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“…LA emptying fraction and LA strain are also reduced in HF with preserved ejection fraction (HFpEF) in clinical studies9, 24, 25 and randomized controlled trials [e.g. Effect of Phosphodiesterase‐5 Inhibition on Exercise Capacity and Clinical Status in Heart Failure with Preserved Ejection Fraction (RELAX trial) substudy26 and Candesartan in Heart failure ‐ Assessment of moRtality and Morbidity (CHARM trial)‐preserved].…”

Section: Prevalence Of Atrial Remodelling In Heart Failurementioning

confidence: 99%

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

et al. 2018

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Section: Prevalence Of Atrial Remodelling In Heart Failurementioning

confidence: 99%

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

et al. 2018

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“…9 Furthermore, recent studies using 2DSTE have supported that LA subendocardial systolic and diastolic dysfunction is common and possibly associated with the same fibrosis processes that affect the LV subendocardial fibers and, to a lesser extent, with elevated LV filling pressures in patients with HFPEF, 23 and that LA deformation mechanics are already impaired in patients with hypertension or diabetes with normal LA size. 24 Also, Oishi et al have found that aortic stiffness increases with age, and that this increase is accelerated in the presence of cardiovascular risk factors, on 2DSTE.…”

Section: Disclosuresmentioning

confidence: 99%

“…28 In contrast, Kurt et al demonstrated that LA strain was significantly lower in patients with HFPEF than in patients with asymptomatic LV diastolic dysfunction. 18 Therefore, "stiff LA" secondary to LA subendocardial fibrotic process in parallel with fibrotic alterations of the LV subendocardial layer 23 and medial degeneration, which leads to progressive stiffening of the large elastic arteries, 29 could also occur in the earlier setting as a result of comorbid conditions, such as hypertension, diabetes, dyslipidemia, obesity, and smoking.…”

Section: Disclosuresmentioning

confidence: 99%

Negative Impact of Cardiovascular Risk Factors on Left Atrial and Left Ventricular Function Related to Aortic Stiffness

Oishi

Miyoshi

Iuchi

et al. 2013

Circ J

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1490OISHI Y et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jp tion, and its relationship with changes in arterial stiffness, namely, LA-LV-arterial coupling. 9 The new angle-independent 2-dimensional speckle-tracking echocardiography (2DSTE) permits the evaluation of not only LA and LV myocardial deformation 9-12 but also aortic and carotid arterial circumferential deformation. 13, 14 The main aim of the present study was to detect earlier the possible effect of cardiovascular risk factors on LA and LV function related to abdominal aortic (AAO) stiffness using 2DSTE in asymptomatic patients, which is likely to prevent the development to HFPEF via the early intervention of statins or angiotensin II receptor blockers with arterio-and cardioprotective effects.reviously, heart failure with preserved ejection fraction (HFPEF) has been attributed to left ventricular (LV) diastolic dysfunction and myocardial stiffness, resulting in elevated LV end-diastolic pressure, 1 particularly in patients with hypertrophic cardiomyopathy. 2 In contrast, cardiovascular risk factors, such as hypertension, diabetes, dyslipidemia, and obesity, have recently been demonstrated to be associated with HFPEF. 3,4 Also, arterial stiffness is widely accepted as a strong predictor of HF symptoms in patients with HFPEF, 5,6 and this increase is accelerated with aging, 7 and in the presence of cardiovascular risk factors. 8 This suggests that HFPEF develops as a progression in asymptomatic patients with cardiovascular risk factors. Previous studies, however, were unable to draw a clear conclusion on the effect of cardiovascular risk factors on left atrial (LA) and LV func- Background: The aim of the present study was to detect earlier the negative effect of cardiovascular risk (CVR) factors on left atrial (LA) and left ventricular (LV) function related to abdominal aortic (AAO) stiffness using 2-dimensional speckle-tracking echocardiography (2DSTE) in asymptomatic patients.

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“…Several and recent studies suggest that the degree of elevated LV filling pressures may not fully explain LA failure and that LA myocardial fibrosis may play a role in the systolic and diastolic dysfunction of the LA. Systolic and diastolic myocardial functions of the LA are disrupted as a result of the fibrosis that occurs in the LA (47) . In pathologies that affect the LA structure and functions, the severity of the LA fibrosis evaluated with the magnetic resonance imaging as well as the correlation between the LA longitudinal strain and strain rate values proves the relationship between involved parameters and LA fibrosis (22) .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Left Atrial Function in Long-Term Anabolic/Androgenic Steroid Users versus Nonuser Bodybuilders by Using Two- Dimensional Speckle-Tracking Echocardiography

Alızade¹

2017

Kosuyolu Heart Journal

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Introduction:Long-term illicit use of supraphysiological doses of anabolic/androgenic steroids (AAS) may cause pathological left ventricular hypertrophy (LVH), diastolic dysfunction, left atrial (LA) hypertrophy, increased myocardial stiffness, and myocardial fibrosis. Therefore, distinguishing AAS-using athlete's hearts from the nonpathological "athlete's heart" is critically important. The aim of this study was to evaluate LA myocardial function using 2D-STE method in both AAS-using and drug-free bodybuilders, and assess its potential role in the differential diagnosis between these two entities. Patients and Methods:We selected a population of 33 male, competitive bodybuilders, including 15 actively using AAS for > 2 years (users) and 18 who had never used AAS (nonusers).Results: AAS users had a significantly lower global LA strain reservoir (GLAS-R), global LA strain during early diastole (GLAS-E; 38.2 ± 8.4 vs. 48.6 ± 11.9, p< 0.01; 24.4 ± 8.6 vs. 37.1 ± 12.8, p< 0.01; respectively), global LA strain rate reservoir (GLASR-R), global LA strain rate during early diastole (GLASR-E; 1.8 ± 0.3 vs. 2.2 ± 0.4, p< 0.01; -1.4 ± 0.2 vs. -1.8 ± 0.3, p< 0.01; respectively) than nonusers. The univariate correlation analysis demonstrated that GLAS-R, GLAS-E, GLASR-R, and GLASR-E had a good inverse correlation with E/Em (r: -0.34, p= 0.04; r: -0.35, p= 0.04; r: -0.35, p= 0.04, and r: -0.35, p= 0.04, respectively). Conclusion:The present study confirms that LA strain and strain rate are impaired in AAS users compared to nonusers and provide valuable additional information to that obtained by conventional echocardiography in the differential diagnosis between pathological and physiological LVH. Bulgular: AAS kullanan atletlerin global SA strain reservoir (GLAS-R), global SA erken diyastol strain (GLAS-E) (38.2 ± 8.4 vs. 48.6 ± 11.9, p< 0.01; 24.4 ± 8.6 vs. 37.1 ± 12.8, p< 0.01; sırasıyla), global SA strain rate reservoir (GLASR-R), global SA erken diyastol strain rate (GLAS-E) (1.8 ± 0.3 vs. 2.2 ± 0.4, p< 0.01; -1.4 ± 0.2 vs. -1.8 ± 0.3, p< 0.01; sırasıyla) değerlerinin kullanmayan sporculara göre önemli ölçüde azaldığı görüldü. Univaryant korelasyon analizi GLAS-R, GLAS-E, GLASR-R ve GLASR-E değerlerinin E/Em (r: -0.34, p = 0.04; r: -0.35, p= 0.04; r: -0.35, p= 0.04 and r: -0.35, p= 0.04, sırasıyla) ile ters korelasyon olduğunu gösterdi.Sonuç: Bu çalışma SA strain ve strain rate değerlerinin AAS kullanan sporcularda kullanmayan sporculara göre azaldığı, ayrıca patolojik ve fizyolojik SVH ayırıcı tanısında konvansiyonel ekokardiyografi ile elde edilen bulgulara ek değerli bilgiler sağladığı doğrulanmıştır.

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Left Atrial Systolic and Diastolic Dysfunction in Heart Failure with Normal Left Ventricular Ejection Fraction

Cited by 125 publications

References 70 publications

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

Atrial remodelling in heart failure: recent developments and relevance for heart failure with preserved ejection fraction

Negative Impact of Cardiovascular Risk Factors on Left Atrial and Left Ventricular Function Related to Aortic Stiffness

Comparison of Left Atrial Function in Long-Term Anabolic/Androgenic Steroid Users versus Nonuser Bodybuilders by Using Two- Dimensional Speckle-Tracking Echocardiography

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