Left atrial stiffness in women with ischemia and no obstructive coronary artery disease : Novel insight from left atrial feature tracking
© 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc..
BACKGROUND: Women with signs and symptoms of ischemia and no obstructive coronary artery disease (INOCA) are at risk of heart failure with preserved ejection fraction (HFpEF); however, the mechanism for HFpEF progression remains unclear. Studies in INOCA have largely focused on left ventricular function. The left atrium serves an important role in maintaining transmitral flow, and is impaired in HFpEF; however, it remains unclear if left atrial function is impaired in INOCA.
HYPOTHESIS: Left atrial function is progressively worse in INOCA and HFpEF compared to controls.
METHODS: We compared 39 reference control subjects to 64 women with INOCA and 22 subjects with HFpEF. Left atrial strain was assessed by feature tracking using magnetic resonance cine images.
RESULTS: Peak left atrial strain was reduced in HFpEF compared to controls (22.9 ± 4.8% vs 25.9 ± 3.2%, P < .01), but similar in INOCA (24.8 ± 4.5%) compared to HFpEF and controls (P = .18). However, left ventricular end-diastolic pressure (LVEDP) was elevated in 33% of INOCA participants, suggesting that left atrial stiffness (LVEDP/LA strain) is elevated in a large portion of women with INOCA.
CONCLUSIONS: Taken together, we interpret these data to support our working hypothesis that INOCA is a pre-HFpEF state, with left atrial stiffness preceding overt left atrial dysfunction; representing a putative therapeutic target to prevent HFpEF progression in this at-risk population.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2020 |
|---|---|
| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:43 |
|---|---|
| Enthalten in: |
Clinical cardiology - 43(2020), 9 vom: 21. Sept., Seite 986-992 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Zamani, Sauyeh K [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Feature tracking |
|---|
| Anmerkungen: |
Date Completed 20.07.2021 Date Revised 17.10.2022 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1002/clc.23395 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM310404673 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM310404673 | ||
| 003 | DE-627 | ||
| 005 | 20231225140022.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2020 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1002/clc.23395 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1034.xml |
| 035 | |a (DE-627)NLM310404673 | ||
| 035 | |a (NLM)32458454 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Zamani, Sauyeh K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Left atrial stiffness in women with ischemia and no obstructive coronary artery disease |b Novel insight from left atrial feature tracking |
| 264 | 1 | |c 2020 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 20.07.2021 | ||
| 500 | |a Date Revised 17.10.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. | ||
| 520 | |a BACKGROUND: Women with signs and symptoms of ischemia and no obstructive coronary artery disease (INOCA) are at risk of heart failure with preserved ejection fraction (HFpEF); however, the mechanism for HFpEF progression remains unclear. Studies in INOCA have largely focused on left ventricular function. The left atrium serves an important role in maintaining transmitral flow, and is impaired in HFpEF; however, it remains unclear if left atrial function is impaired in INOCA | ||
| 520 | |a HYPOTHESIS: Left atrial function is progressively worse in INOCA and HFpEF compared to controls | ||
| 520 | |a METHODS: We compared 39 reference control subjects to 64 women with INOCA and 22 subjects with HFpEF. Left atrial strain was assessed by feature tracking using magnetic resonance cine images | ||
| 520 | |a RESULTS: Peak left atrial strain was reduced in HFpEF compared to controls (22.9 ± 4.8% vs 25.9 ± 3.2%, P < .01), but similar in INOCA (24.8 ± 4.5%) compared to HFpEF and controls (P = .18). However, left ventricular end-diastolic pressure (LVEDP) was elevated in 33% of INOCA participants, suggesting that left atrial stiffness (LVEDP/LA strain) is elevated in a large portion of women with INOCA | ||
| 520 | |a CONCLUSIONS: Taken together, we interpret these data to support our working hypothesis that INOCA is a pre-HFpEF state, with left atrial stiffness preceding overt left atrial dysfunction; representing a putative therapeutic target to prevent HFpEF progression in this at-risk population | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a feature tracking | |
| 650 | 4 | |a heart failure with preserved ejection fraction | |
| 650 | 4 | |a ischemia with no obstructive coronary artery disease | |
| 650 | 4 | |a left atrial strain | |
| 700 | 1 | |a Samuel, Thomas Jake |e verfasserin |4 aut | |
| 700 | 1 | |a Wei, Janet |e verfasserin |4 aut | |
| 700 | 1 | |a Thomson, Louise E J |e verfasserin |4 aut | |
| 700 | 1 | |a Tamarappoo, Balaji |e verfasserin |4 aut | |
| 700 | 1 | |a Sharif, Behzad |e verfasserin |4 aut | |
| 700 | 1 | |a Bairey Merz, C Noel |e verfasserin |4 aut | |
| 700 | 1 | |a Nelson, Michael D |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Clinical cardiology |d 1992 |g 43(2020), 9 vom: 21. Sept., Seite 986-992 |w (DE-627)NLM000419834 |x 1932-8737 |7 nnns |
| 773 | 1 | 8 | |g volume:43 |g year:2020 |g number:9 |g day:21 |g month:09 |g pages:986-992 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1002/clc.23395 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 43 |j 2020 |e 9 |b 21 |c 09 |h 986-992 | ||