ArticleEuropean heart journal. Cardiovascular Imaging2021
The prognostic impact of mechanical atrial dysfunction and atrial fibrillation in heart failure with preserved ejection fraction.
Article in European heart journal. Cardiovascular Imaging, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Pooled it
- Left atrial dysfunction can independently predict exercise capacity in patients with chronic heart failure who use beta-blockers.BMC cardiovascular disorders · 2023Trial
- The clinical pathophysiology of atrial fibrillation: outstanding questions from bedside to bench and back.Physiological reviews · 2026Review
- Baseline remodeling-dependent changes in left atrial strain after catheter ablation for paroxysmal atrial fibrillation.Journal of echocardiography · 2026Article
- Role of imaging techniques in monitoring atrial cardiomyopathy and atrial failure: a scientific statement.ESC heart failure · 2026Review
- Atrial cardiomyopathy: markers and outcomes.European heart journal · 2026Article
- A simplified approach for diagnosing heart failure with preserved ejection fraction by assessing the left atrium and natriuretic peptides.European journal of heart failure · 2025Article
- Atrial cardiomyopathy: From healthy atria to atrial failure. A clinical consensus statement of the Heart Failure Association of the ESC.European journal of heart failure · 2025Article
- Discordance between left atrial pressure and risk scores in assessment of heart failure with preserved ejection fraction in patients with atrial fibrillation undergoing catheter ablation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Fibroblast-Restricted Inflammasome Activation Promotes Atrial Fibrillation and Heart Failure With Diastolic Dysfunction.JACC. Basic to translational science · 2025Article
- Inter-atrial block as a predictor of adverse outcomes in patients with HFpEF.ESC heart failure · 2025Article
- Running on empty: Factors underpinning impaired cardiac output reserve in heart failure with preserved ejection fraction.Experimental physiology · 2025Review
- Temporal prevalence and prognostic impact of diabetes mellitus and albuminuria in heart failure with preserved ejection fraction.Cardiovascular diabetology · 2025Observational
- Retinal Vascular Changes in Heart Failure with Preserved Ejection Fraction UsingJournal of clinical medicine · 2024Article
- Cardiac reverse remodelling by imaging parameters with recent changes to guideline medical therapy in heart failure.ESC heart failure · 2023Review
- Webtool to enhance the accuracy of diagnostic algorithms for HFpEF: a prospective cross-over study.ESC heart failure · 2023Article
- Association of left ventricular strain-volume loop characteristics with adverse events in patients with heart failure with preserved ejection fraction.European heart journal. Cardiovascular Imaging · 2023Article
- Association between phonocardiography and echocardiography in heart failure patients with preserved ejection fraction.European heart journal. Digital health · 2023Article
- Effect of Weight Loss on Early Left Atrial Myopathy in People With Obesity But No Established Cardiovascular Disease.Journal of the American Heart Association · 2022Article
Corrections and comments
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Authors and funding
15 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsThis study assessed the prognostic implications of mechanical atrial dysfunction in heart failure with preserved ejection fraction (HFpEF) patients with different stages of atrial fibrillation (AF) in detail. METHODS AND
resultsHFpEF patients (n = 258) systemically underwent an extensive clinical characterization, including 24-h Holter monitoring and speckle-tracking echocardiography. Patients were categorized according to rhythm and stages of AF: 112 with no history of AF (no AF), 56 with paroxysmal AF (PAF), and 90 with sustained (persistent/permanent) AF (SAF). A progressive decrease in mechanical atrial function was seen: left atrial reservoir strain (LASr) 30.5 ± 10.5% (no AF), 22.3 ± 10.5% (PAF), and 13.9 ± 7.8% (SAF), P < 0.001. Independent predictors for lower LASr values were AF, absence of chronic obstructive pulmonary disease, higher N-terminal-pro hormone B-type natriuretic peptide, left atrial volume index, and relative wall thickness, lower left ventricular global longitudinal strain, and echocardiographic signs of elevated left ventricular filling pressure. LASr was an independent predictor of adverse outcome (hazard ratio per 1% decrease =1.049, 95% confidence interval 1.014-1.085, P = 0.006), whereas AF was not when the multivariable model included LASr. Moreover, LASr mediated the adverse outcome associated with AF in HFpEF (P = 0.008).
conclusionMechanical atrial dysfunction has a possible greater prognostic role in HFpEF compared to AF status alone. Mechanical atrial dysfunction is a predictor of adverse outcome independently of AF presence or stage, and may be an underlying mechanism (mediator) for the worse outcome associated with AF in HFpEF. This may suggest mechanical atrial dysfunction plays a crucial role in disease progression in HFpEF patients with AF, and possibly also in HFpEF patients without AF.
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