Evidence map›Paper›PMID 31401742›Full record

Observational studyThe international journal of cardiovascular imaging2020

Left atrial ejection fraction and outcomes in heart failure with preserved ejection fraction.

Prathap Kanagala, Jayanth R Arnold, Adrian S H Cheng, Anvesha Singh, Jamal N Khan, Gaurav S Gulsin, Jing Yang, Lei Zhao, Pankaj Gupta, Iain B Squire and 2 more

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in The international journal of cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 2 pooled it
4.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Prathap KanagalaDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK. pkk12@leicester.ac.uk.ORCID http://orcid.org/0000-0001-6739-5607
Jayanth R ArnoldDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Adrian S H ChengKettering General Hospital NHS Foundation Trust, Kettering, UK.
Anvesha SinghDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Jamal N KhanDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Gaurav S GulsinDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Jing YangBristol-Myers Squibb, Princeton, NJ, USA.
Lei ZhaoBristol-Myers Squibb, Princeton, NJ, USA.
Pankaj GuptaDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Iain B SquireDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Leong L NgDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
Gerry P McCannDepartment of Cardiovascular Sciences, University of Leicester, National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, UK.
University of Leicester · GBBristol-Myers Squibb (United States) · USKettering General Hospital · GBUniversity of Liverpool · GB

Funding

Department of Health RP-2017-08-ST2-007National Institute for Health Research CDF 2014-07-045National Institute for Health Research PDF-2011-0451National Institute for Health Research (NIHR) Leicester Cardiovascular Biomedical Research Centre Overall project Grant: IRS_BRU_0211_20033
6 · The paper itself

Abstract

The aim of this study was to determine whether left atrial ejection fraction (LAEF) quantified with cardiovascular magnetic resonance (CMR) was different between heart failure with preserved ejection fraction (HFpEF) and controls, and its relation to prognosis. As part of our single-centre, prospective, observational study, 188 subjects (HFpEF n = 140, controls n = 48) underwent phenotyping with contrast-enhanced CMR, transthoracic echocardiography, blood sampling and six-minute walk testing. LAEF was calculated using the biplane method. Atrial fibrillation (AF) was present in 43 (31%) of HFpEF subjects. Overall, LAEF (%) was lower in HFpEF patients inclusive of AF (32 ± 16) or those in sinus rhythm alone (41 ± 12) compared to controls (51 ± 11), p < 0.0001. LAEF correlated inversely with maximal and minimal left atrial volumes indexed (r =  - 0.602, r =  - 0.762), and plasma N-terminal pro-atrial natriuretic peptide (r =  - 0.367); p < 0.0001. During median follow-up (1429 days), there were 67 composite events of all-cause death or hospitalization for heart failure (22 deaths, 45 HF hospitalizations) in HFpEF. Lower LAEF (below median) was associated with an increased risk of composite endpoints (Log-Rank: all p = 0.028; sinus p = 0.036). In multivariable Cox regression analysis, LAEF (adjusted hazard ratio [HR] 0.767, 95% confidence interval [CI] 0.591-0.996; p = 0.047) and indexed extracellular volume (HR 1.422, CI 1.015-1.992; p = 0.041) were the only parameters that remained significant when added to a base prognostic model comprising age, prior HF hospitalization, diastolic blood pressure, lung disease, NYHA, six-minute-walk-test-distance, haemoglobin, creatinine and B-type natriuretic peptide. CMR-derived LAEF is lower in HFpEF compared to healthy controls and is a strong prognostic biomarker.

Indexed as

Atrial Function, LeftStroke VolumeVentricular Function, LeftAgedAged, 80 and overBiomarkersCase-Control StudiesDisease ProgressionEchocardiographyExercise ToleranceFemaleHeart FailureHumansMagnetic Resonance Imaging, CineMaleMiddle AgedBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)BiomarkerCardiovascular magnetic resonance imagingHeart failure with preserved ejection fractionLeft atrial ejection fractionPrognosis

Identifiers

PMID31401742
PMCPMC6942575
OpenAlexW2968901723

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.