Prognostic value of left atrial reverse remodelling in patients hospitalized with acute decompensated heart failure.
LA reverse remodelling
LAVI
acute decompensated heart failure
Journal
ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191
Informations de publication
Date de publication:
26 Aug 2024
26 Aug 2024
Historique:
revised:
15
07
2024
received:
24
04
2024
accepted:
30
07
2024
medline:
27
8
2024
pubmed:
27
8
2024
entrez:
27
8
2024
Statut:
aheadofprint
Résumé
Left atrial (LA) volume index (LAVI) in chronic heart failure (HF) predicts cardiovascular outcomes. However, the association between LAVI reduction during acute decompensated HF (ADHF) and its prognostic potential is limited. We hypothesized that LA reverse remodelling (LARR) after ADHF therapy would be associated with better clinical outcomes. This retrospective study analysed clinical outcomes and the LAVI reduction rate of 363 out of 861 patients hospitalized for ADHF who underwent two-point echocardiography at admission and discharge between January 2015 and December 2019. The mean age was 74.3 ± 13.6 years, and the mean ejection fraction (EF) was 38.9 ± 15.2%. The follow-up echocardiogram was performed 13.0 [9.5, 20] days after admission. As the median LAVI reduction rate was 7.02%, the LARR was defined as an LAVI reduction rate >7%. During the 34.0 ± 20.2 months of follow-up, 117 patients (32.2%) reached the primary endpoint defined as cardiovascular death and rehospitalization for ADHF. Kaplan-Meier survival analysis showed that patients with LARR had a better prognosis. Multivariate analysis indicated that LARR was an independent predictor of cardiovascular events. Similar findings were observed in the subgroup analyses of patients with persistent/permanent atrial fibrillation and those with non-HF with reduced EF. Among patients who were brain natriuretic peptide (BNP) responders, defined as a relative reduction of >70% in BNP from admission to discharge, non-LARR was observed in 41.6%. BNP responders without LARR experienced worse prognoses. LARR in the early vulnerable phase after hospitalization for ADHF was associated with better long-term clinical outcomes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.
Références
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, Fonarow GC, et al. Forecasting the impact of heart failure in the United States: A policy statement from the American Heart Association. Circ Heart Fail 2013;6:606‐619. doi:10.1161/HHF.0b013e318291329a
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599‐3726. doi:10.1093/eurheartj/ehab368
Ambrosy AP, Fonarow GC, Butler J, Chioncel O, Greene SJ, Vaduganathan M, et al. The global health and economic burden of hospitalizations for heart failure: Lessons learned from hospitalized heart failure registries. J Am Coll Cardiol 2014;63:1123‐1133. doi:10.1016/j.jacc.2013.11.053
Khan MS, Sreenivasan J, Lateef N, Abougergi MS, Greene SJ, Ahmad T, et al. Trends in 30‐ and 90‐day readmission rates for heart failure. Circ Heart Fail 2021;14:e008335. doi:10.1161/CIRCHEARTFAILURE.121.008335
Fudim M, O'Connor CM, Dunning A, Ambrosy AP, Armstrong PW, Coles A, et al. Aetiology, timing and clinical predictors of early vs. late readmission following index hospitalization for acute heart failure: Insights from ASCEND‐HF. Eur J Heart Fail 2018;20:304‐314. doi:10.1002/ejhf.1020
Khan H, Greene SJ, Fonarow GC, Kalogeropoulos AP, Ambrosy AP, Maggioni AP, et al. Length of hospital stay and 30‐day readmission following heart failure hospitalization: Insights from the EVEREST trial. Eur J Heart Fail 2015;17:1022‐1031. doi:10.1002/ejhf.282
Arundel C, Lam PH, Khosla R, Blackman MR, Fonarow GC, Morgan C, et al. Association of 30‐day all‐cause readmission with long‐term outcomes in hospitalized older Medicare beneficiaries with heart failure. Am J Med 2016;129:1178‐1184. doi:10.1016/j.amjmed.2016.06.018
Hernandez AF, Greiner MA, Fonarow GC, Hammill BG, Heidenreich PA, Yancy CW, et al. Relationship between early physician follow‐up and 30‐day readmission among Medicare beneficiaries hospitalized for heart failure. JAMA 2010;303:1716‐1722. doi:10.1001/jama.2010.533
Tanaka H, Nabeshima Y, Kitano T, Nagumo S, Tsujiuchi M, Ebato M, et al. Optimal timing of echocardiography for heart failure inpatients in Japanese institutions: OPTIMAL study. ESC Heart Fail 2020;7:4213‐4221. doi:10.1002/ehf2.13050
Douglas PS. The left atrium: A biomarker of chronic diastolic dysfunction and cardiovascular disease risk. J Am Coll Cardiol 2003;42:1206‐1207. doi:10.1016/s0735‐1097(03)00956‐2
Tsang TS, Abhayaratna WP, Barnes ME, Miyasaka Y, Gersh BJ, Bailey KR, et al. Prediction of cardiovascular outcomes with left atrial size: Is volume superior to area or diameter? J Am Coll Cardiol 2006;47:1018‐1023. doi:10.1016/j.jacc.2005.08.077
Poulsen MK, Dahl JS, Henriksen JE, Hey TM, Høilund‐Carlsen PF, Beck‐Nielsen H, et al. Left atrial volume index: Relation to long‐term clinical outcome in type 2 diabetes. J Am Coll Cardiol 2013;62:2416‐2421. doi:10.1016/j.jacc.2013.08.1622
Rossi A, Temporelli PL, Quintana M, Dini FL, Ghio S, Hillis GS, et al. Independent relationship of left atrial size and mortality in patients with heart failure: An individual patient meta‐analysis of longitudinal data (MeRGE Heart Failure). Eur J Heart Fail 2009;11:929‐936. doi:10.1093/eurjhf/hfp112
Solti F, Vecsey T, Kékesi V, Juhász‐Nagy A. The effect of atrial dilatation on the genesis of atrial arrhythmias. Cardiovasc Res 1989;23:882‐886. doi:10.1093/cvr/23.10.882
Melenovsky V, Hwang SJ, Redfield MM, Zakeri R, Lin G, Borlaug BA. Left atrial remodeling and function in advanced heart failure with preserved or reduced ejection fraction. Circ Heart Fail 2015;8:295‐303. doi:10.1161/CIRCHEARTFAILURE.114.001667
McKee PA, Castelli WP, McNamara PM, Kannel WB. The natural history of congestive heart failure: The Framingham study. N Engl J Med 1971;285:1441‐1446. doi:10.1056/NEJM197112232852601
Stienen S, Salah K, Eurlings LW, Bettencourt P, Pimenta JM, Metra M, et al. Challenging the two concepts in determining the appropriate pre‐discharge N‐terminal pro‐brain natriuretic peptide treatment target in acute decompensated heart failure patients: Absolute or relative discharge levels? Eur J Heart Fail 2015;17:936‐944. doi:10.1002/ejhf.320
Lang RM, Badano LP, Mor‐Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2015;16:233‐270. doi:10.1093/ehjci/jev014
Florescu DR, Badano LP, Tomaselli M, Torlasco C, Târtea GC, Bălșeanu TA, et al. Automated left atrial volume measurement by two‐dimensional speckle‐tracking echocardiography: Feasibility, accuracy, and reproducibility. Eur Heart J Cardiovasc Imaging 2021;23:85‐94. doi:10.1093/ehjci/jeab199
Tsujiuchi M, Yamauchi T, Ebato M, Maezawa H, Nogi A, Ikeda N, et al. Prognostic value of left atrial size and functional indices measured by 3‐dimensional speckle‐tracking analysis. Circ J 2019;83:801‐808. doi:10.1253/circj.CJ‐18‐0554
Khan MS, Memon MM, Murad MH, Vaduganathan M, Greene SJ, Hall M, et al. Left atrial function in heart failure with preserved ejection fraction: A systematic review and meta‐analysis. Eur J Heart Fail 2020;22:472‐485. doi:10.1002/ejhf.1643
Carluccio E, Biagioli P, Mengoni A, Francesca Cerasa M, Lauciello R, Zuchi C, et al. Left atrial reservoir function and outcome in heart failure with reduced ejection fraction: The importance of atrial strain by speckle tracking echocardiography. Circ Cardiovasc Imaging 2018;11:e007696. doi:10.1161/CIRCIMAGING.118.007696
Boixel C, Fontaine V, Rücker‐Martin C, Milliez P, Louedec L, Michel JB, et al. Fibrosis of the left atria during progression of heart failure is associated with increased matrix metalloproteinases in the rat. J Am Coll Cardiol 2003;42:336‐344. doi:10.1016/s0735‐1097(03)00578‐3
Takahashi Y, Yamaguchi T, Otsubo T, Nakashima K, Shinzato K, Osako R, et al. Histological validation of atrial structural remodelling in patients with atrial fibrillation. Eur Heart J 2023;44:3339‐3353. doi:10.1093/eurheartj/ehad396
Zile MR, Gottdiener JS, Hetzel SJ, McMurray JJ, Komajda M, McKelvie R, et al. Prevalence and significance of alterations in cardiac structure and function in patients with heart failure and a preserved ejection fraction. Circulation 2011;124:2491‐2501. doi:10.1161/CIRCULATIONAHA.110.011031
Olsson LG, Swedberg K, Ducharme A, Granger CB, Michelson EL, McMurray JJ, et al. Atrial fibrillation and risk of clinical events in chronic heart failure with and without left ventricular systolic dysfunction: Results from the Candesartan in Heart failure‐Assessment of Reduction in Mortality and morbidity (CHARM) program. J Am Coll Cardiol 2006;47:1997‐2004.
D'Andrea A, Caso P, Romano S, Scarafile R, Cuomo S, Salerno G, et al. Association between left atrial myocardial function and exercise capacity in patients with either idiopathic or ischemic dilated cardiomyopathy: A two‐dimensional speckle strain study. Int J Cardiol 2009;132:354‐363. doi:10.1016/j.ijcard.2007.11.102
Deferm S, Martens P, Verbrugge FH, Bertrand PB, Dauw J, Verhaert D, et al. LA mechanics in decompensated heart failure: Insights from strain echocardiography with invasive hemodynamics. JACC Cardiovasc Imaging 2020;13:1107‐1115. doi:10.1016/j.jcmg.2019.12.008
Rossi A, Cicoira M, Zanolla L, Sandrini R, Golia G, Zardini P, et al. Determinants and prognostic value of left atrial volume in patients with dilated cardiomyopathy. J Am Coll Cardiol 2002;40:1425‐1430. doi:10.1016/s0735‐1097(02)02305‐7
Rossi A, Carluccio E, Cameli M, Inciardi RM, Mandoli GE, D'Agostino A, et al. Left atrial structural and mechanical remodelling in heart failure with reduced ejection fraction. ESC Heart Fail 2021;8:4751‐4759. doi:10.1002/ehf2.13654
Nagueh SF, Smiseth OA, Appleton CP, Byrd BF III, Dokainish H, Edvardsen T, et al. Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging 2016;17:1321‐1360. doi:10.1093/ehjci/jew082
Eapen ZJ, Reed SD, Li Y, Kociol RD, Armstrong PW, Starling RC, et al. Do countries or hospitals with longer hospital stays for acute heart failure have lower readmission rates?: Findings from ASCEND‐HF. Circ Heart Fail 2013;6:727‐732. doi:10.1161/CIRCHEARTFAILURE.112.000265