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Left atrial stiffness predicts cardiac events in patients with heart failure and reduced ejection fraction: The impact of diabetes.


ABSTRACT:

Background

The aim of this study was to investigate the relationship between diabetes mellitus (DM) and left atrial (LA) remodelling in a group of patients with heart failure and reduced ejection fraction (HFrEF), and their combined impact on cardiac events (CE).

Methods

This study included 136 consecutive HFrEF patients (65 ± 11 years), 36 had DM, and 86 had increased LA stiffness (LASt). All patients underwent complete conventional and tissue Doppler echocardiographic measurements were made including LA volumes and function. LASt was calculated using the formula: LASt = E/e' ratio / PALS.

Results

At 55 ± 37 months follow-up, free survival from CE was 69% in patients without DM and 44.4% in those with DM (p < .0001). The CE free survival was lower in patients with increased LASt compared to normal LASt, (50 versus. 80%, p < .001), irrespective of the presence of DM (27 versus. 71%, p < .001).The best cut-off value of LASt for predicting CE in the group as a whole was ? 0.82% [81% sensitivity, 72% specificity and AUC 0.82 (p < .001)]. LASt ? 0.82% also predicted CE in no DM patients [78% sensitivity, 71% specificity and AUC 0.80 (p < .001)] and was a stronger predictor in DM patients [85% sensitivity, 71% specificity and AUC = 0.847 (p < .001)].

Conclusion

High LA stiffness is associated with poor clinical outcome in patients with HFrEF. Diabetes has an additional incremental value in determining clinical outcome in those patients.

SUBMITTER: Bytyci I 

PROVIDER: S-EPMC7898664 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Left atrial stiffness predicts cardiac events in patients with heart failure and reduced ejection fraction: The impact of diabetes.

Bytyçi Ibadete I   D'Agostino Andreina A   Bajraktari Gani G   Lindqvist Per P   Dini Frank L FL   Henein Michael Y MY  

Clinical physiology and functional imaging 20210103 2


<h4>Background</h4>The aim of this study was to investigate the relationship between diabetes mellitus (DM) and left atrial (LA) remodelling in a group of patients with heart failure and reduced ejection fraction (HFrEF), and their combined impact on cardiac events (CE).<h4>Methods</h4>This study included 136 consecutive HFrEF patients (65 ± 11 years), 36 had DM, and 86 had increased LA stiffness (LASt). All patients underwent complete conventional and tissue Doppler echocardiographic measuremen  ...[more]

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