Relation of left atrial overload indices with prognostic endpoints in heart failure and preserved ejection fraction. (2nd March 2022)

• Record Type: Journal Article
• Authors: Hoshida, Shiro; Tachibana, Koichi; Shinoda, Yukinori; Minamisaka, Tomoko; Seo, Masahiro; Yano, Masamichi; Hayashi, Takaharu; Nakagawa, Akito; Nakagawa, Yusuke; Tamaki, Shunsuke; Yamada, Takahisa; Yasumura, Yoshio; Sotomi, Yohei; Hikoso, Shungo; Nakatani, Daisaku; Sakata, Yasushi
• Other Names: Seo Masahiro investigator.; Watanabe Tetsuya investigator.; Yamada Takahisa investigator.; Hayashi Takaharu investigator.; Higuchi Yoshiharu investigator.; Masuda Masaharu investigator.; Asai Mitsutoshi investigator.; Mano Toshiaki investigator.; Fuji Hisakazu investigator.; Masuda Daisaku investigator.; Tamaki Shunsuke investigator.; Shutta Ryu investigator.; Yamashita Shizuya investigator.; Sairyo Masami investigator.; Nakagawa Yusuke investigator.; Abe Haruhiko investigator.; Ueda Yasunori investigator.; Matsumura Yasushi investigator.; Nagai Kunihiko investigator.; Yano Masamichi investigator.; Nishino Masami investigator.; Tanouchi Jun investigator.; Arita Yoh investigator.; Ogasawara Nobuyuki investigator.; Ishizu Takamaru investigator.; Ichikawa Minoru investigator.; Takano Yuzuru investigator.; Rin Eisai investigator.; Shinoda Yukinori investigator.; Tachibana Koichi investigator.; Hoshida Shiro investigator.; Izumi Masahiro investigator.; Yamamoto Hiroyoshi investigator.; Kato Hiroyasu investigator.; Nakatani Kazuhiro investigator.; Yasuga Yuji investigator.; Nishio Mayu investigator.; Hirooka Keiji investigator.; Yoshimura Takahiro investigator.; Yasuoka Yoshinori investigator.; Tani Akihiro investigator.; Okumoto Yasushi investigator.; Makino Yasunaka investigator.; Onishi Toshinari investigator.; Iwakura Katsuomi investigator.; Kijima Yoshiyuki investigator.; Kitao Takashi investigator.; Kanai Hideyuki investigator.; Fujita Masashi investigator.; Harada Koichiro investigator.; Kumada Masahiro investigator.; Nakagawa Osamu investigator.; Araki Ryo investigator.; Yamada Takayuki investigator.; Nakagawa Akito investigator.; Yasumura Yoshio investigator.; Sato Taiki investigator.; Sunaga Akihiro investigator.; Oeun Bolrathanak investigator.; Kida Hirota investigator.; Sotomi Yohei investigator.; Dohi Tomoharu investigator.; Nakamoto Kei investigator.; Okada Katsuki investigator.; Sera Fusako investigator.; Kioka Hidetaka investigator.; Ohtani Tomohito investigator.; Takeda Toshihiro investigator.; Nakatani Daisaku investigator.; Mizuno Hiroya investigator.; Hikoso Shungo investigator.; Sakata Yasushi investigator.;
• Is Part Of: ESC heart failure. Volume 9:Number 3(2022)
• Page Start: 1784
• Page End: 1791
• Publication Date: 2022-03-02
• Subjects: Arterial elastance -- Diastolic elastance -- Elderly -- Endpoint -- HFpEF -- Prognosis; Heart failure -- Periodicals; 616.129005
• DOI: 10.1002/ehf2.13865
• Languages: English
• ISSNs: 2055-5822

Abstract

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.