Impact of Right Atrial Remodeling in Heart Failure With Preserved Ejection Fraction |
| |
| Authors: | Takahiro Ikoma Masaru Obokata Kenya Okada Tomonari Harada Hidemi Sorimachi Kuniko Yoshida Toshimitsu Kato Koji Kurosawa Masahiko Kurabayashi Masami Murakami |
| |
| Affiliation: | 1. Department of Clinical Laboratory, Gunma University Hospital, Maebashi, Gunma, Japan;2. Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan;3. Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan;1. Division of Cardiovascular Surgery, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;2. Cardiovascular Division, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;1. Department of Medicine, Brigham and Women''s Hospital, Boston, Massachusetts;2. Harvard Medical School, Boston, Massachusetts;3. Department of Medicine, Cardiology Section, VA Boston Healthcare System, Boston, Massachusetts;1. Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California;2. Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California;3. Division of Cardiology, VA Greater Los Angeles Healthcare System, Los Angeles, California;1. The Department of Cardiovascular Medicine, Mayo Clinic Rochester, MN;2. Institute for Clinical and Experimental Medicine, Prague, Czech Republic;3. Division of Cardiology, Columbia University Medical Center, New York, NY;1. Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut;2. Yale National Clinicians Scholar Program, New Haven, Connecticut;3. Department of Critical Care and Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada;4. Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland;5. Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, New York;6. Division of Cardiology, Royal Columbian Hospital, University of British Columbia, New Westminster, British Columbia, Canada;7. Canadian VIGOUR Centre, University of Alberta, Alberta, Edmonton, Canada;8. Division of Cardiology, Duke University Medical Center, Durham, North Carolina;9. Division of Cardiology, Department of Medicine, Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada |
| |
| Abstract: | BackgroundFew studies have investigated right atrial (RA) remodeling in heart failure (HF) with preserved ejection fraction (HFpEF). This study sought to characterize the RA remodeling in HFpEF and to determine its prognostic significance.Methods and ResultsPatients with HFpEF were classified based on the presence of RA enlargement (RA volume index >39 mL/m2 in men and >33 mL/m2 in women). Compared with patients with normal RA size (n = 234), patients with RA dilation (n = 67) showed a higher prevalence of atrial fibrillation (AF), worse right ventricular systolic function, more severe pulmonary hypertension, and a greater prevalence of mild tricuspid regurgitation, as well as impaired RA reservoir function, with increased hepatobiliary enzyme levels. AF was strongly associated with the presence of RA dilation (odds ratio [OR] 10.2, 95% confidence interval [CI] 4.00–26.1 in current AF vs no AF and odds ratio 3.38, 95% CI 1.26–9.07, earlier AF vs no AF). Patients with RA dilation had more than a two-fold increased risk of composite outcomes of all-cause mortality or HF hospitalization (adjusted hazard ratio 2.01, 95% CI 1.09–3.70, P = .02). The presence of RA dilation also displayed an additive prognostic value over left atrial dilation alone.ConclusionsThese data demonstrate that HFpEF with RA remodeling is associated with distinct echocardiographic features characterizing advanced right heart dysfunction with an increased risk of adverse outcomes. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
