Reverse Atrial Remodeling in Heart Failure With Recovered Ejection Fraction

Sun, Yuxi; Chen, Xuefu; Yao, Yu; Zhang, Xinxin; Si, Jinping; Ding, Zijie; Xia, Yunlong; Tse, Gary

doi:10.1161/jaha.122.026891

Cited by 10 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is now known that not only left ventricular remodelling but also LA remodelling has prognostic significance. A recent publication suggests that an improved LVEF in HFrEF is associated with a higher rate of LA remodelling 37 . Further, LA remodelling, like left ventricular remodelling, predicts a better prognosis and lower mortality and morbidity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and predictors of heart failure with improved ejection fraction category in a HFrEF patient population

Solymossi,

Muk,

Sepp

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

AimsThe aim of the study was to assess the incidence and predictive factors of the development of heart failure with improved ejection fraction (HFimpEF) category during a 1 year follow‐up period in a heart failure with reduced ejection fraction (HFrEF) patient population managed in a heart failure outpatient clinic.Methods and resultsThe study evaluated data from patients enrolled in the Hungarian Heart Failure Registry (HHFR). The incidence and predictive factors of the development of the HFimpEF category after 1 year follow‐up were assessed in the group of patients who had HFrEF at baseline. We evaluated the incidence and predictors of the development of HFimpEF after a 1 year follow‐up in relation to time since diagnosis of HFrEF in patients diagnosed within 3 months, between 3 months and 1 year, and beyond 1 year. The predictive factors of the development of HFimpEF were analysed using univariate and multivariate logistic regression analysis. Of the 833 HFrEF patients enrolled in the HHFR, the development of HFimpEF was observed in 162 patients (19.5%) during 1 year follow‐up. In the whole patient population, independent predictors of the development of HFimpEF were female gender [odds ratio (OR): 1.73; 95% confidence interval (CI): 1.01–2.96; P < 0.05], non‐ischaemic aetiology (OR: 1.95; 95% CI: 1.15–3.30; P < 0.05), and left ventricular end‐diastolic diameter (LVEDD) <60 mm (OR: 2.04; 95% CI: 1.18–3.51; P < 0.05). The 1 year incidence of HFimpEF decreased in relation to time since diagnosis of HFrEF. The incidence of HFimpEF was 27.1% in patients diagnosed within 3 months, 18.4% in patients diagnosed between 3 months and 1 year, and 12.2% in patients diagnosed beyond 1 year. Non‐ischaemic aetiology (OR: 4.76; 95% CI: 1.83–12.4; P < 0.01) and QRS width (OR: 0.81; 95% CI: 0.71–0.94; P < 0.01) for patients diagnosed within 3 months, LVEDD (OR: 0.54; 95% CI: 0.32–0.90; P < 0.05) and left atrial diameter ≤45 mm (OR: 5.44; 95% CI: 1.45–20.4; P < 0.05) for patients diagnosed between 3 months and 1 year, and LVEDD < 67 mm (OR: 2.71; 95% CI: 1.07–6.88; P < 0.05) for patients diagnosed beyond 1 year were found to be independent predictive factors.ConclusionsIn our study, in this HFrEF patient population managed in a heart failure outpatient clinic, the 1 year incidence of HFimpEF was found to be ~20%. The 1 year incidence of HFimpEF decreased in relation to time since diagnosis of HFrEF. The most important predictors of the development of HFimpEF were female sex, non‐ischaemic aetiology, narrower QRS width, and smaller diameter of the left ventricle and left atrium.

show abstract

Section: Discussionmentioning

confidence: 99%

“…A recent publication suggests that an improved LVEF in HFrEF is associated with a higher rate of LA remodelling. 37 Further, LA remodelling, like left ventricular remodelling, predicts a better prognosis and lower mortality and morbidity.…”

Section: Discussionmentioning

confidence: 99%

Incidence and predictors of heart failure with improved ejection fraction category in a HFrEF patient population

Solymossi,

Muk,

Sepp

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

show abstract

“…In this sense, systolic [ 29 , 30 ] and diastolic [ 31 , 32 ] HF increase left atrial pressure. It has been recently shown that left atrial size is a good predictor of HF in human patients [ 33 ] . Atrial hypertrophy [ 9 , 28 , 34 ] and increased left atrial fibrosis [ 35 , 36 ] have been previously described in the cTAC model, but no analysis of atria structure or function has been reported so far in the mTAC model.…”

Section: Discussionmentioning

confidence: 99%

Characterization of atrial and ventricular remodeling in an improved minimally invasive mouse model of transverse aortic constriction

Navarro‐García¹,

Lahiri²,

Aguilar-Sánchez³

et al. 2023

J Cardiovasc Aging

View full text Add to dashboard Cite

Introduction: Heart failure (HF) is the leading cause of death worldwide. Most large and small animal disease models of HF are based on surgical procedures. A common surgical technique to induce HF is transverse aortic constriction (TAC), which induces pressure overload. The conventional TAC (cTAC) procedure is a highly invasive surgery that is associated with severe inflammation and excessive perioperative deaths. Aim: To establish an improved, minimally invasive TAC (mTAC) procedure that does not require thoracotomy. Methods and results: Following anesthesia, mice were intubated, and a small incision was made at the neck and chest. After cutting the sternum about 4 mm, the aortic arch was approached without opening the pleural cavity. A suture was placed between the brachiocephalic artery and the left common carotid artery. This model was associated with low perioperative mortality and a highly reproducible constriction evidenced by an increased right-to-left carotid blood flow velocity ratio in mTAC mice (5.9 ± 0.2) vs. sham controls (1.2 ± 0.1; p < 0.001). mTAC mice exhibited progressive cardiac remodeling during the 8 weeks post-TAC, resulting in reduced left ventricular (LV) contractility, increased LV end-systolic diameter, left atrial enlargement and diastolic dysfunction, and an increased heart weight to tibia length ratio (mTAC: 15.0 ± 0.8 vs. sham: 10.1 ± 0.6; p < 0.01). Conclusion: Our data show that the mTAC procedure yields a highly reproducible phenotype consisting of LV contractile dysfunction and enlargement, combined with left atrial enlargement and diastolic dysfunction. Potential impact of the findings: This model may be used to test the molecular mechanisms underlying atrial remodeling associated with HF development or to evaluate therapeutic strategies to treat these conditions.

show abstract

“…Even when these patients have improved clinical outcomes, they remain at risk for recurrent HF, especially if significant cardiac remodeling occurs before rhythm control is achieved [ 21 ]. However, those with left atrial reverse remodeling (about 60 %) have a better prognosis [ 22 ].…”

Section: Impact Of Af On Patients With Hfpefmentioning

confidence: 99%

A review of the impact, pathophysiology, and management of atrial fibrillation in patients with heart failure with preserved ejection fraction

Dye,

Dela Cruz,

Larsen

et al. 2023

American Heart Journal Plus: Cardiology Research and Practice

View full text Add to dashboard Cite

Reverse Atrial Remodeling in Heart Failure With Recovered Ejection Fraction

Cited by 10 publications

References 36 publications

Incidence and predictors of heart failure with improved ejection fraction category in a HFrEF patient population

Incidence and predictors of heart failure with improved ejection fraction category in a HFrEF patient population

Characterization of atrial and ventricular remodeling in an improved minimally invasive mouse model of transverse aortic constriction

A review of the impact, pathophysiology, and management of atrial fibrillation in patients with heart failure with preserved ejection fraction

Contact Info

Product

Resources

About