Diastolic Heart Failure Predicted by Left Atrial Expansion Index in Patients with Severe Diastolic DysfunctionReportar como inadecuado




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Background

Left atrial LA echocardiographic parameters are increasingly used to predict clinically relevant cardiovascular events. The study aims to evaluate the LA expansion index LAEI for predicting diastolic heart failure HF in patients with severe left ventricular LV diastolic dysfunction.

Methods

This prospective study enrolled 162 patients 65% male with preserved LV systolic function and severe diastolic dysfunction 132 grade 2 patients, 30 grade 3 patients. All patients had sinus rhythm at enrollment. The LAEI was calculated as Volmax - Volmin x 100% - Volmin, where Volmax was defined as maximal LA volume and Volmin was defined as minimal volume. The endpoint was hospitalization for HF withp reserved LV ejection fraction HFpEF.

Results

The median follow-up duration was 2.9 years. Fifty-four patients had cardiovascular events, including 41 diastolic and 8 systolic HF hospitalizations. In these 54 patients, 13 in-hospital deaths and 5 sudden out-of-hospital deaths occurred. Multivariate analyses revealed that HFpEF was associated with LAEI.and atrial fibrillation during follow-up. For predicting HFpEF, the LAEI had a hazard ratio of 1.197per 10% decrease. In patients who had HFpEF events, the LAEI significantly P< 0.0001 decreased from 69±18% to 39±11% during hospitalization. Although the LAEI improved during follow-up 53±13%, it did not return to baseline.

Conclusions

The LAEI predicts HFpEF in patients with severe diastolic dysfunction; it worsens during HFpEF events and partially recovers during followup.



Autor: Shih-Hung Hsiao, Kuan-Rau Chiou

Fuente: http://plos.srce.hr/



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