ArticleEuropean journal of heart failure2022
Clinical implications of left atrial changes after optimization of medical therapy in patients with heart failure.
Article in European journal of 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.
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8 citing papers in PubMed, 15 citations in OpenAlex.
- Left atrial strain on 2D-STE in pediatric dilated cardiomyopathy.Echo research and practice · 2026Article
- Predictive value of left atrial diameter and epicardial adipose tissue in sleep apnea and heart failure with preserved ejection fraction.Frontiers in cardiovascular medicine · 2026Article
- Prognostic significance of atrial functional mitral regurgitation in patients with HFpEF and end-stage renal disease.Frontiers in cardiovascular medicine · 2026Article
- 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
- Cardiac remodelling in the era of the recommended four pillars heart failure medical therapy.ESC heart failure · 2025Review
- Ultrasound assessment of the association between left atrial remodeling and fibrosis in patients with valvular atrial fibrillation: a clinical investigation.BMC cardiovascular disorders · 2025Article
- Prognosis and Risk Stratification in Dilated Cardiomyopathy With LVEF≤35%: Cardiac MRI Insights for Better Outcomes.Circulation. Cardiovascular imaging · 2025Article
- Effect of short-term cardiac function changes after cardiac resynchronization therapy on long-term prognosis in heart failure patients with and without diabetes.Therapeutic advances in chronic disease · 2024Article
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17 authors at 13 institutions in 9 countries.
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Abstract
aimsLimited data exist regarding the prognostic relevance of changes in left atrial (LA) dimensions in patients with heart failure (HF). We assessed changes in LA dimension and their relation with outcomes after optimization of guideline-directed medical therapy (GDMT) in patients with new-onset or worsening HF. METHODS AND
resultsLeft atrial diameter was assessed at baseline and 9 months after GDMT optimization in 632 patients (mean age 65.8 ± 12.1 years, 22.3% female) enrolled in BIOSTAT-CHF. LA adverse remodelling (LAAR) was defined as an increase in LA diameter on transthoracic echocardiography between baseline and 9 months. After the 9-month visit, patients were followed for a median of 13 further months. LAAR was observed in 247 patients (39%). Larger baseline LA diameter (odds ratio [OR] 0.90; 95% confidence interval [CI] 0.87-0.93; p < 0.001) and up-titration to higher doses of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEi/ARBs) (OR 0.56; 95% CI 0.34-0.92; p = 0.022) were independently associated with lower likelihood of LAAR. LAAR was associated with an increased risk of the composite of all-cause mortality or HF hospitalization (log-rank p = 0.007 and adjusted hazard ratio 1.73, 95% CI 1.22-2.45, p = 0.002). The association was more pronounced in patients without a history of atrial fibrillation (p for interaction = 0.009).
conclusionAmong patients enrolled in BIOSTAT-CHF, LAAR was associated with an unfavourable outcome and was prevented by ACEi/ARB up-titration. Changes in LA dimension may be a useful marker of response to treatment and improve risk stratification in patients with HF.
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