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Relationship between the strain measures of left atrial function and heart failure worsening
  • +10
  • Massimo Iacoviello,
  • Davide Diomede,
  • Erica Terazzi,
  • Nicolangelo Diomede,
  • Gianmarco Alcidi,
  • Rosanna Pugliese,
  • Sara Ioannoni,
  • Matteo Romano,
  • Michele Granatiero,
  • Vito Di Terlizzi,
  • Michele Correale,
  • Matteo Di Biase,
  • Natale Daniele Brunetti
Massimo Iacoviello
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche

Corresponding Author:massimo.iacoviello@gmail.com

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Davide Diomede
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Erica Terazzi
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Nicolangelo Diomede
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Gianmarco Alcidi
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Rosanna Pugliese
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Sara Ioannoni
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Matteo Romano
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Michele Granatiero
Azienda Ospedaliera Universitaria Foggia
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Vito Di Terlizzi
Azienda Ospedaliera Universitaria Foggia
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Michele Correale
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Matteo Di Biase
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Natale Daniele Brunetti
Universita degli Studi di Foggia Dipartimento di Scienze Mediche e Chirurgiche
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Abstract

Background. Two-dimensional speckle tracking evaluation (2D-STE) is a useful tool to evaluate the complexity of atrial function by the analysis of the different phases of atrial deformation and by the combination with Doppler measurements of diastolic function. Aim of the study. To evaluate the role of the left atrial (LA) strain parameters to predict worsening chronic heart failure (CHF). Methods. We enrolled outpatients affected by CHF referred to our heart failure unit. Each patient underwent a medical visit, an electrocardiogram (ECG), and an echocardiographic examination. LA function was assessed by 2D-STE. The three phases of LA strain – i.e. the reservoir (LAr), the conduit (LAcd), and the contraction (LAct) – were evaluated. Moreover, the ratio between LAr and that of septal (LAr/Ees), lateral (LAr/Eel), and septal-lateral (LAr/Eem) E/e’ were evaluated. During follow-up, the worsening of heart failure was evaluated. Results. Two hundred twenty-eight patients were enrolled. During a mean follow-up of 14±7 months, 47 patients showed at least one event related to heart failure worsening (40 hospitalisations, 5 heart transplantations, and 19 cardiovascular deaths). During univariate Cox regression analysis, LAr, LAcd, LAct, LAr/Ees, LAr/Eel, and LAr/Eem were all associated with events related to heart failure worsening, but during multivariate regression analysis, only LAr (HR: 0.94; 95% CI: 0.91–0.98; p: 0.007), LAr/Ees (HR: 0.49; 95% CI: 0.30–0.78; p: 0.002), and LAr/Eem (HR: 0.65; 95% CI: 0.47–0.89; p: 0.008) remained significantly associated with the events. Finally, LASr/Ee’s showed accuracy in predicting outcomes greater than LASr (C-index 0.78 vs. 0.72, respectively). Conclusions. In CHF patients, the measure of the LA reservoir by 2D-STE is independently associated with heart failure worsening, but the accuracy in predicting the events is even greater when the reservoir is combined with the Doppler measures of diastolic function.
12 Apr 2023Submitted to Echocardiography
12 Apr 2023Submission Checks Completed
12 Apr 2023Assigned to Editor
28 Apr 2023Reviewer(s) Assigned
20 May 2023Review(s) Completed, Editorial Evaluation Pending
21 May 2023Editorial Decision: Revise Major
03 Jun 20231st Revision Received
06 Jun 2023Submission Checks Completed
06 Jun 2023Assigned to Editor
06 Jun 2023Reviewer(s) Assigned
11 Jun 2023Review(s) Completed, Editorial Evaluation Pending
14 Jun 2023Editorial Decision: Revise Major
19 Jun 20232nd Revision Received
19 Jun 2023Submission Checks Completed
19 Jun 2023Assigned to Editor
19 Jun 2023Reviewer(s) Assigned
24 Jun 2023Review(s) Completed, Editorial Evaluation Pending
29 Jun 2023Editorial Decision: Revise Minor
03 Jul 20233rd Revision Received
03 Jul 2023Submission Checks Completed
03 Jul 2023Assigned to Editor
03 Jul 2023Reviewer(s) Assigned
08 Jul 2023Review(s) Completed, Editorial Evaluation Pending
16 Jul 2023Editorial Decision: Accept