Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction
Abstract Aims Considerable variation in the relationships between the indices of left atrial (LA) volume and pressure could possibly affect the selection of medications or efforts to improve the prognoses of patients with heart failure and preserved ejection fraction (HFpEF). We aimed to clarify the...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-06-01
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| Series: | ESC Heart Failure |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/ehf2.13865 |
| _version_ | 1818205923624091648 |
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| author | Shiro Hoshida Koichi Tachibana Yukinori Shinoda Tomoko Minamisaka Masahiro Seo Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Takahisa Yamada Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Yasushi Sakata OCVC‐Heart Failure Investigators |
| author_facet | Shiro Hoshida Koichi Tachibana Yukinori Shinoda Tomoko Minamisaka Masahiro Seo Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Takahisa Yamada Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Yasushi Sakata OCVC‐Heart Failure Investigators |
| author_sort | Shiro Hoshida |
| collection | DOAJ |
| description | Abstract Aims Considerable variation in the relationships between the indices of left atrial (LA) volume and pressure could possibly affect the selection of medications or efforts to improve the prognoses of patients with heart failure and preserved ejection fraction (HFpEF). We aimed to clarify the association between the prognostic endpoint and LA overload indices in elderly patients with HFpEF. Methods and results We analysed 898 patients with HFpEF hospitalized for acute decompensated heart failure (men/women: 406/492). Blood tests and transthoracic echocardiography were performed before discharge. The primary endpoint was re‐admission for heart failure or all‐cause mortality. Stroke volume (SV)/left atrial volume (LAV), an index for LA volume overload, was a significant prognostic factor of re‐admission for heart failure in the multivariable Cox hazard analysis adjusted for comorbidities [hazard ratio (HR) 0.616, 95% confidence interval (CI) 0.430–0.882, P = 0.008]. Additionally, the ratio of diastolic elastance (Ed) to arterial elastance (Ea), an index for LA pressure overload, was also significant (HR 1.444, 95% CI 1.014–2.058, P = 0.041). Furthermore, Ed/Ea, but not SV/LAV, was a significant prognostic factor of all‐cause mortality (HR 1.594, 95% CI 1.102–2.306, P = 0.013). Conclusions The index of LA overload for prognosis may differ according to the different endpoints in elderly patients with HFpEF. |
| first_indexed | 2024-12-12T04:04:51Z |
| format | Article |
| id | doaj.art-775d375a5e1e4ab685b5ece2b6c7a0c2 |
| institution | Directory Open Access Journal |
| issn | 2055-5822 |
| language | English |
| last_indexed | 2024-12-12T04:04:51Z |
| publishDate | 2022-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | ESC Heart Failure |
| spelling | doaj.art-775d375a5e1e4ab685b5ece2b6c7a0c22022-12-22T00:38:47ZengWileyESC Heart Failure2055-58222022-06-01931784179110.1002/ehf2.13865Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fractionShiro Hoshida0Koichi Tachibana1Yukinori Shinoda2Tomoko Minamisaka3Masahiro Seo4Masamichi Yano5Takaharu Hayashi6Akito Nakagawa7Yusuke Nakagawa8Shunsuke Tamaki9Takahisa Yamada10Yoshio Yasumura11Yohei Sotomi12Shungo Hikoso13Daisaku Nakatani14Yasushi Sakata15OCVC‐Heart Failure InvestigatorsDepartment of Cardiovascular Medicine Yao Municipal Hospital 1‐3‐1 Ryuge‐cho Yao Osaka 581‐0069 JapanDepartment of Cardiovascular Medicine Yao Municipal Hospital 1‐3‐1 Ryuge‐cho Yao Osaka 581‐0069 JapanDepartment of Cardiovascular Medicine Yao Municipal Hospital 1‐3‐1 Ryuge‐cho Yao Osaka 581‐0069 JapanDepartment of Cardiovascular Medicine Yao Municipal Hospital 1‐3‐1 Ryuge‐cho Yao Osaka 581‐0069 JapanDivision of Cardiology Osaka General Medical Center Osaka JapanDivision of Cardiology Osaka Rosai Hospital Sakai JapanCardiovascular Division Osaka Police Hospital Osaka JapanDivision of Cardiology Amagasaki‐Chuo Hospital Amagasaki JapanDivision of Cardiology Kawanishi City Hospital Kawanishi JapanDepartment of Cardiology Rinku General Medical Center Izumisano JapanDivision of Cardiology Osaka General Medical Center Osaka JapanDivision of Cardiology Amagasaki‐Chuo Hospital Amagasaki JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanDepartment of Cardiovascular Medicine Osaka University Graduate School of Medicine Suita JapanAbstract Aims Considerable variation in the relationships between the indices of left atrial (LA) volume and pressure could possibly affect the selection of medications or efforts to improve the prognoses of patients with heart failure and preserved ejection fraction (HFpEF). We aimed to clarify the association between the prognostic endpoint and LA overload indices in elderly patients with HFpEF. Methods and results We analysed 898 patients with HFpEF hospitalized for acute decompensated heart failure (men/women: 406/492). Blood tests and transthoracic echocardiography were performed before discharge. The primary endpoint was re‐admission for heart failure or all‐cause mortality. Stroke volume (SV)/left atrial volume (LAV), an index for LA volume overload, was a significant prognostic factor of re‐admission for heart failure in the multivariable Cox hazard analysis adjusted for comorbidities [hazard ratio (HR) 0.616, 95% confidence interval (CI) 0.430–0.882, P = 0.008]. Additionally, the ratio of diastolic elastance (Ed) to arterial elastance (Ea), an index for LA pressure overload, was also significant (HR 1.444, 95% CI 1.014–2.058, P = 0.041). Furthermore, Ed/Ea, but not SV/LAV, was a significant prognostic factor of all‐cause mortality (HR 1.594, 95% CI 1.102–2.306, P = 0.013). Conclusions The index of LA overload for prognosis may differ according to the different endpoints in elderly patients with HFpEF.https://doi.org/10.1002/ehf2.13865Arterial elastanceDiastolic elastanceElderlyEndpointHFpEFPrognosis |
| spellingShingle | Shiro Hoshida Koichi Tachibana Yukinori Shinoda Tomoko Minamisaka Masahiro Seo Masamichi Yano Takaharu Hayashi Akito Nakagawa Yusuke Nakagawa Shunsuke Tamaki Takahisa Yamada Yoshio Yasumura Yohei Sotomi Shungo Hikoso Daisaku Nakatani Yasushi Sakata OCVC‐Heart Failure Investigators Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction ESC Heart Failure Arterial elastance Diastolic elastance Elderly Endpoint HFpEF Prognosis |
| title | Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| title_full | Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| title_fullStr | Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| title_full_unstemmed | Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| title_short | Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| title_sort | relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction |
| topic | Arterial elastance Diastolic elastance Elderly Endpoint HFpEF Prognosis |
| url | https://doi.org/10.1002/ehf2.13865 |
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