Evidence map›Paper›PMID 34874122›Full record

Observational studyESC heart failure2022

New echocardiographic indices of shift to biventricular failure to optimize risk stratification of chronic heart failure.

Giulia Elena Mandoli, Maria Concetta Pastore, Giovanni Benfari, Martina Setti, Dan Nistor, Flavio D'Ascenzi, Marta Focardi, Bernardo Baccani, Giuseppe Patti, Serafina Valente and 2 more

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

Observational study in ESC heart failure, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.4field-weighted citation impact, top 16% 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

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Article
  6. Article
  7. Observational
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 3 countries.

Giulia Elena MandoliDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.ORCID 0000-0002-3184-3006
Maria Concetta PastoreDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.ORCID 0000-0002-7223-141X
Giovanni BenfariDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Martina SettiDivision of Cardiology, Department of Medicine, University of Verona, Verona, Italy.
Dan NistorDepartment M3, University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Târgu Mureș, Romania.
Flavio D'AscenziDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.
Marta FocardiDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.
Bernardo BaccaniDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.
Giuseppe PattiDepartment of Thoracic and Cardiovascular Diseases, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy.
Serafina ValenteDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.
Sergio MondilloDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.
Matteo CameliDivision of Cardiology, Department of Medical Biotechnologies, University of Siena, Viale Bracci 1, Siena, 53100, Italy.ORCID 0000-0003-3872-8964
University of Siena · ITUniversity of Verona · ITUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · ITUniversitatea de Medicină, Farmacie, Științe și Tehnologie „George Emil Palade” din Târgu Mureș · RO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe present study investigated the prognostic impact of either isolated left atrial (LA) impairment, or its association with right ventricular (RV) failure, in heart failure (HF) with reduced ejection fraction (HFrEF), using basic and speckle tracking echocardiography (STE). METHODS AND

resultsOne hundred and six outpatients with HFrEF were enrolled in this prospective observational study. Patients with primary lung diseases, non-sinus rhythm, previous cardiac surgery, and poor acoustic window were excluded. After clinical examination and basic echocardiography, STE was used to measure peak atrial longitudinal strain (PALS) and a new marker of RV performance and pulmonary circulation relation: free-wall RV longitudinal strain (fwRVLS)/systolic pulmonary artery pressure (sPAP). Patients were followed for all-cause/cardiovascular death and HF hospitalization. Of 84 eligible patients (60.1 ± 11.5 years; 82% male patients), 48 reached the combined endpoint (cardiovascular death and/or HF hospitalization). Population was divided into three groups: Group 1 (PALS ≥ 15 and fwRVLS/sPAP ≤ -0.5), Group 2 (PALS ≤ 15 and fwRVLS/sPAP ≤ -0.5), and Group 3 (PALS ≤ 15 and fwRVLS/sPAP > -0.5). Mean follow up was 3.5 ± 0.3 years. The higher severity groups were associated with higher LA volume index (P < 0.0001), New York Heart Association class (P = 0.02), mitral regurgitation (P = 0.0004) and tricuspid regurgitation grades (P < 0.0001), lower left ventricular (LV) ejection fraction (P = 0.0003), LV global longitudinal strain (P < 0.0001), PALS (P < 0.0001), tricuspid annular plane systolic excursion (P < 0.007), sPAP (P < 0.0001), and RV strain (P < 0.0001). Reduced PALS and fwRVLS/sPAP were independent predictors of the combined endpoint with adjusted Cox models (hazard ratio = 9.54; 95% confidence interval = 2.95-30.92; P = 0.0002 for Group 3 vs. Group 1). Kaplan-Meier curves showed early and persistent divergence between the three groups for the prediction of the combined endpoint and of all-cause death (P < 0.0001).

conclusionsThe combination of LA and right heart damage entails worse prognosis in patients with HFrEF. The evaluation of PALS and fwRVLS/sPAP could aid risk stratification of HFrEF patients to provide them early treatment.

Indexed as

Heart FailureEchocardiographyFemaleHumansMaleRisk AssessmentStroke VolumeVentricular Function, LeftEchocardiographyHeart failureLeft atrialPrognosisPulmonary pressureRight ventricular

Identifiers

PMID34874122
PMCPMC8788050
OpenAlexW4200318014

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.