Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction

ObjectiveThe left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertension-related heart failure with preserved ejection fr...

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Main Authors: Qingfeng Zhang, Sijia Wang, Hongmei Zhang, Kai Wang, Wenhua Li, Geqi Ding, Luwei Ye, Chunmei Li, Yan Deng, Yi Wang, Lixue Yin
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Cardiovascular Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2024.1501004/full
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author Qingfeng Zhang
Qingfeng Zhang
Sijia Wang
Sijia Wang
Hongmei Zhang
Kai Wang
Wenhua Li
Geqi Ding
Luwei Ye
Chunmei Li
Yan Deng
Yi Wang
Lixue Yin
Lixue Yin
author_facet Qingfeng Zhang
Qingfeng Zhang
Sijia Wang
Sijia Wang
Hongmei Zhang
Kai Wang
Wenhua Li
Geqi Ding
Luwei Ye
Chunmei Li
Yan Deng
Yi Wang
Lixue Yin
Lixue Yin
author_sort Qingfeng Zhang
collection DOAJ
description ObjectiveThe left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertension-related heart failure with preserved ejection fraction (HT-HFpEF).MethodsThe study involved 62 healthy subjects and 163 patients with HT (112 patients in simple HT group and 51 patients in HT-HFpEF group). Each patient performed exercise stress test and standard ultrasonic images were evaluated. A comprehensive evaluation of atrioventricular function, along with investigation into the correlation between these functional parameters and exercise capacity. And further to investigate the feasibility of predicting exercise intolerance using three-dimensional derived left atrial strain index (LASI) (E/e'/LASr and E/e'/LASr-c).ResultsCompared to healthy subjects, HT group demonstrated the elevation in left atrial volume accompanied by decrease in strain value (P < 0.05). In HT-HFpEF group, further significant reductions were observed in both longitudinal (LASr) and circumferential strain (LASr-c, LASct-c) (P < 0.05). Univariate regression demonstrated that both E/e'/LASr and E/e'/LASr-c were significantly correlated with metabolic equivalents (METs) (r = −0.462, P < 0.001; r = −0.381, P < 0.001). The E/e'/LASr demonstrates comparable diagnostic efficacy to exercise-E/e' in assessing exercise intolerance in HT-HFpEF patients (AUC: 0.836 vs. 0.867, P = 0.239).ConclusionProgressive LA remodeling contributes to decreased atrioventricular compliance in HT and HT-HFpEF patients.E/e'/LASr serves as an independent indicator of exercise intolerance in patients with HT-HFpEF.
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spelling doaj-art-942f86bcd8e345178fc75ade7c0357a32025-08-20T02:36:49ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2024-12-011110.3389/fcvm.2024.15010041501004Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fractionQingfeng Zhang0Qingfeng Zhang1Sijia Wang2Sijia Wang3Hongmei Zhang4Kai Wang5Wenhua Li6Geqi Ding7Luwei Ye8Chunmei Li9Yan Deng10Yi Wang11Lixue Yin12Lixue Yin13School of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Acute Care Surgery, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaSchool of Medicine, University of Electronic Science and Technology of China, Chengdu, ChinaDepartment of Cardiovascular Ultrasound and Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, ChinaObjectiveThe left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertension-related heart failure with preserved ejection fraction (HT-HFpEF).MethodsThe study involved 62 healthy subjects and 163 patients with HT (112 patients in simple HT group and 51 patients in HT-HFpEF group). Each patient performed exercise stress test and standard ultrasonic images were evaluated. A comprehensive evaluation of atrioventricular function, along with investigation into the correlation between these functional parameters and exercise capacity. And further to investigate the feasibility of predicting exercise intolerance using three-dimensional derived left atrial strain index (LASI) (E/e'/LASr and E/e'/LASr-c).ResultsCompared to healthy subjects, HT group demonstrated the elevation in left atrial volume accompanied by decrease in strain value (P < 0.05). In HT-HFpEF group, further significant reductions were observed in both longitudinal (LASr) and circumferential strain (LASr-c, LASct-c) (P < 0.05). Univariate regression demonstrated that both E/e'/LASr and E/e'/LASr-c were significantly correlated with metabolic equivalents (METs) (r = −0.462, P < 0.001; r = −0.381, P < 0.001). The E/e'/LASr demonstrates comparable diagnostic efficacy to exercise-E/e' in assessing exercise intolerance in HT-HFpEF patients (AUC: 0.836 vs. 0.867, P = 0.239).ConclusionProgressive LA remodeling contributes to decreased atrioventricular compliance in HT and HT-HFpEF patients.E/e'/LASr serves as an independent indicator of exercise intolerance in patients with HT-HFpEF.https://www.frontiersin.org/articles/10.3389/fcvm.2024.1501004/fullthree-dimensional speckle trackingleft atrialhypertensionstiffnessheart failure
spellingShingle Qingfeng Zhang
Qingfeng Zhang
Sijia Wang
Sijia Wang
Hongmei Zhang
Kai Wang
Wenhua Li
Geqi Ding
Luwei Ye
Chunmei Li
Yan Deng
Yi Wang
Lixue Yin
Lixue Yin
Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
Frontiers in Cardiovascular Medicine
three-dimensional speckle tracking
left atrial
hypertension
stiffness
heart failure
title Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
title_full Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
title_fullStr Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
title_full_unstemmed Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
title_short Evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension-related heart failure with preserved ejection fraction
title_sort evaluation of left atrial function and the relationship between left atrial stiffness index and exercise capacity in hypertension related heart failure with preserved ejection fraction
topic three-dimensional speckle tracking
left atrial
hypertension
stiffness
heart failure
url https://www.frontiersin.org/articles/10.3389/fcvm.2024.1501004/full
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