1. Left atrial strain is a predictor of left ventricular systolic and diastolic reverse remodelling in CRT candidates
- Author
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Virginie Le Rolle, Arnaud Hubert, Cecilia Linde, Martin Penicka, Emmanuel Oger, Otto A. Smiseth, Elena Galli, Jens-Uwe Voigt, Alfredo Hernandez, John M Aalen, Christophe Leclercq, Alban Gallard, Elif Sade, C K Larsen, Erwan Donal, Jürgen Duchenne, Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Pontchaillou [Rennes], Recherche en Pharmaco-épidémiologie et Recours aux Soins (REPERES), Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP), University of Oslo (UiO), Oslo University Hospital [Oslo], Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Başkent University Hospital [Adana, Turkey], University of Pittsburgh (PITT), Pennsylvania Commonwealth System of Higher Education (PCSHE), OLV Ziekenhuis [Aslst], Karolinska Institutet [Stockholm], Centre for Cardiological Innovation, Norwegian Health Association, South-Eastern Norway Regional Health Authority, OT12/084, University Leuven, FKM1832917N, Research Foundation Flanders, Novartis, Bayer, Astra Zeneca, Medtronic, Radiodiagnostics, and Impulse Dynamics, The University Hospital of Rennes receives research facilities from GE Healthcare, Jonchère, Laurent, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Heart Ventricles ,Diastole ,Cardiac resynchronization therapy ,Left atrium ,cardiac resynchronization therapy ,heart failure ,030204 cardiovascular system & hematology ,Independent predictor ,Left atrial strain ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Ventricular Dysfunction, Left ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Heart Atria ,[SDV.IB] Life Sciences [q-bio]/Bioengineering ,Ejection fraction ,Heart Murmurs ,left atrial strain ,business.industry ,General Medicine ,medicine.disease ,medicine.anatomical_structure ,Treatment Outcome ,Echocardiography ,Heart failure ,Cardiology ,cardiovascular system ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,Cardiology and Cardiovascular Medicine ,business - Abstract
Aims The left atrium (LA) has a pivotal role in cardiac performance and LA deformation is a well-known prognostic predictor in several clinical conditions including heart failure with reduced ejection fraction. The aim of this study is to investigate the effect of cardiac resynchronization therapy (CRT) on both LA morphology and function and to assess the impact of LA reservoir strain (LARS) on left ventricular (LV) systolic and diastolic remodelling after CRT. Methods and results Two hundred and twenty-one CRT-candidates were prospectively included in the study in four tertiary centres and underwent echocardiography before CRT-implantation and at 6-month follow-up (FU). CRT-response was defined by a 15% reduction in LV end-systolic volume. LV systolic and diastolic remodelling were defined as the percent reduction in LV end-systolic and end-diastolic volume at FU. Indexed LA volume (LAVI) and LV-global longitudinal (GLS) strain were the main parameters correlated with LARS, with LV-GLS being the strongest determinant of LARS (r = −0.59, P < 0.0001). CRT induced a significant improvement in LAVI and LARS in responders (both P < 0.0001). LARS was an independent predictor of both LV systolic and diastolic remodelling at follow-up (r = −0.14, P = 0.049 and r = −0.17, P = 0.002, respectively). Conclusion CRT induces a significant improvement in LAVI and LARS in responders. In CRT candidates, the evaluation of LARS before CRT delivery is an independent predictor of LV systolic and diastolic remodelling at FU.
- Published
- 2022