Heart failure & cardiomyopathies
Diagnostic Value of Reduced Left Atrial Compliance During Ergometry Exercise in Heart Failure with Preserved Ejection Fraction
Authors' conclusion
Left atrial compliance during exercise demonstrated superior diagnostic ability to exercise E/e' ratio, with incremental diagnostic value over the resting LA compliance.
Study context
- Population
- Patients with chronic dyspnoea: Heart failure with preserved ejection fraction (HFpEF) vs non-cardiac dyspnoea (NCD) controls; HFpEF by HFA-PEFF algorithm (Protocol 1) or exercise right heart catheterization (Protocol 2)Protocol 1: 225 HFpEF, 262 NCD
- Comparison
- Exercise left atrial (LA) compliance vs exercise E/e' ratio for diagnosing HFpEF
- Outcome
- Diagnostic value of exercise LA compliance for HFpEF
Methodological detailstwo protocols, exercise stress echocardiography, speckle-tracking echocardiography
- Two protocols
- Exercise stress echocardiography
- Speckle-tracking echocardiography
Performance
As reported in the abstract
Discrimination of HFpEF from NCD
| Test or model | AUC |
|---|---|
| Exercise LA compliance | 0.87 |
Exercise LA compliance
AUC0.87
- Exercise LA compliance vs Exercise E/e' ratio: DeLong p = 0.005 — superior diagnostic ability
- Exercise LA compliance AUC p value
- P < 0.0001
Further findings
Incremental diagnostic value over clinical factors (age, hypertension, AF) and resting LA compliance
- χ2 212.4 vs. 166.2
- P < 0.0001
LA reservoir strain and compliance, HFpEF vs NCD
- Decreased in HFpEF at rest; differences further increased during exercise (Protocol 1)
Protocol 2 (exercise right heart catheterization, n = 67: 49 HFpEF, 18 NCD)
- Findings confirmed
Original publication
Diagnostic Value of Reduced Left Atrial Compliance During Ergometry Exercise in Heart Failure with Preserved Ejection Fraction. Eur J Heart Fail. Published 26 April 2023. doi:10.
Summarised from the published abstract; every number is checked against it