Heart failure & cardiomyopathies
Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure
Authors' conclusion
In patients with AdHF, reduced global PALS strongly correlated with the invasively assessed LV filling pressure and degree of LV fibrosis.
Study context
- Population
- Patients with advanced HF undergoing heart transplantation
- Participants
- 64 patients
- Outcome
- Relationship between left atrial (LA) peak atrial longitudinal strain (PALS) by speckle-tracking echocardiography and invasive LV filling pressures and LV fibrosis
Methodological detailsconsecutive enrolment, single-centre
- Consecutive enrolment
- Single-centre
Main finding
As reported in the abstract
- Global peak atrial longitudinal strain (PALS) vs pulmonary capillary wedge pressure (PCWP), correlation R
- −0.83; P < 0.0001
- Global PALS vs left ventricular (LV) fibrosis severity, correlation R
- −0.78; P < 0.0001
- Global PALS vs LV ejection fraction (LVEF), correlation R (no correlation)
- 0.15; P = 0.2
- Global PALS for raised (>18 mmHg) PCWP, AUC (strongest echocardiographic predictor)
- 0.955 (95% CI 0.87-0.99)
- Mean LVEF
- 26.7 ± 6.1%
- Global PALS
- 9.65 ± 4.5%
- Mean PCWP
- 18.8 ± 4.8 mmHg
- Severe LV fibrosis
- 73%
Observational data: associations, not effects.
Original publication
Left ventricular fibrosis as a main determinant of filling pressures and left atrial function in advanced heart failure. Eur Heart J Cardiovasc Imaging. Published 18 December 2023. doi:10.
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