Evidence map›Paper›PMID 40357557›Full record

ArticleCirculation. Heart failure2025

Left Atrial Reverse Remodeling in Patients Supported With Durable Left Ventricular Assist Devices and Clinical Implications.

Christos P Kyriakopoulos, Konstantinos Sideris, Iosif Taleb, Eleni Maneta, Eleni Tseliou, Jake Aadland, Andrew S Baird, Michael J Bonios, Marisca Nelson, Elizabeth Dranow and 9 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation. Heart failure, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Outcomes of donation after circulatory death heart transplant using normothermic regional perfusion: a systematic review and meta-analysis.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026
    Pooled it
  2. Review
  3. 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

19 authors.

Christos P KyriakopoulosDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0001-9415-1245
Konstantinos SiderisDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0009-0007-9369-0782
Iosif TalebDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-0029-5019
Eleni ManetaNora Eccles Harrison Cardiovascular Research and Training Institute, University of Utah, Salt Lake City (C.P.K., E.M., E. Tseliou, C.H.S., S.G.D.).ORCID 0000-0001-5011-3036
Eleni TseliouDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-9350-2282
Jake AadlandDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.
Andrew S BairdDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0001-8123-8675
Michael J BoniosDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0003-0425-6532
Marisca NelsonDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.
Elizabeth DranowDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-5324-192X
Matthew L GoodwinDivision of Cardiothoracic Surgery, Department of Surgery (M.L.G., C.H.S.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0009-0001-7315-5287
Thomas C HanffDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0003-3096-1227
Spencer CarterDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0001-7268-3689
Craig H SelzmanDivision of Cardiothoracic Surgery, Department of Surgery (M.L.G., C.H.S.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0001-9218-4764
Josef StehlikDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-7362-0513
Omar Wever-PinzonDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-2828-707X
Satvik RamakrishnaDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.
Ethan TumarkinDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-2710-7671
Stavros G DrakosDivision of Cardiovascular Medicine, Department of Internal Medicine (C.P.K., K.S., I.T., E. Tseliou, J.A., A.S.B., M.J.B., M.N., E.D., T.C.H., S.C., J.S., O.W.-P., S.R., E. Tumarkin, S.G.D.), University of Utah Health and School of Medicine, Salt Lake City.ORCID 0000-0002-1223-327X

Funding

CTSA UM1 Program at University of UtahUM1TR004409 · NCATS · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI RACHEL HESS, Jennifer Juhl Majersik · 2023 to 2026
$21.9M
TRAINING IN CARDIOVASCULAR RESEARCHT32HL007576 · NHLBI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Stavros George Drakos, Robin M Shaw · 1985 to 2026
$10.6M
Mechanism of Eccentric Cardiomyocyte Hypertrophy Secondary to Mitral RegurgitationR01HL166513 · NHLBI · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Stavros George Drakos · 2023 to 2026
$2.4M
Clinical and Metabolic Signature of Recovered Myocardium in Human Heart FailureR01HL135121 · NHLBI · UNIVERSITY OF UTAH · PI DRAKOS, STAVROS GEORGE · 2017 to 2021
$1.9M
Cellular Remodeling in Heart Failure and after LVAD UnloadingR01HL132067 · NHLBI · UNIVERSITY OF UTAH · PI DRAKOS, STAVROS GEORGE, SACHSE, FRANK BERND · 2017 to 2020
$1.5M
Role of DNA methylation in cardiac failure and recoveryK23HL150322 · NHLBI · UNIVERSITY OF UTAH · PI WEVER-PINZON, OMAR ENRIQUE · 2020 to 2024
$994k
BLRD VA I01 BX006306CSRD VA I01 CX002291NCATS NIH HHS UM1 TR004409NHLBI NIH HHS K23 HL150322NHLBI NIH HHS R01 HL132067NHLBI NIH HHS R01 HL135121NHLBI NIH HHS R01 HL166513NHLBI NIH HHS T32 HL007576
6 · The paper itself

Abstract

backgroundThe left atrium (LA) maintains a dynamic interaction with the left ventricle (LV). LA forward and reverse remodeling affect prognosis in patients with chronic heart failure. We examined LA reverse remodeling in patients supported with LV assist devices (LVADs) and investigated a potential impact on clinical outcomes.

methodsConsecutive patients with advanced heart failure receiving durable, continuous-flow LVADs were prospectively evaluated (n=263). After excluding patients with unavailable echocardiographic data, 241 patients were studied. Echocardiographic assessment was performed pre- and serially post-LVAD implantation. We assessed LA and LV structure and function and their association, and the impact of LA reverse remodeling on all-cause mortality, LVAD-related adverse events, and atrial fibrillation (AF).

resultsMost patients were male, White, with a mean age of 56±15 years. Forty-four percent had underlying ischemic cardiomyopathy, and 65% were profile 1 to 3 as per the Interagency Registry for Mechanically Assisted Circulatory Support, with a mean LV ejection fraction of 19±7%, and end-diastolic diameter of 6.7±1.1 cm pre-LVAD. LA structure and function improved by 1 month on LVAD support and remained improved by 12 months, as evidenced by LA volumes, emptying volumes, emptying fractions, and strain parameters. LA changes were shown to be associated with LV structural and functional changes. The magnitude of LA reverse remodeling was associated with all-cause mortality, but not cerebrovascular accident/transient ischemic attack, LVAD thrombosis, or late right heart failure rates by 12 months on LVAD support. Of 46 patients with AF pre-LVAD, 28 (61%) converted to sinus rhythm, and 18 (39%) remained in AF during serial echocardiographic assessment.

conclusionsLA structure and function improved early post-LVAD support, showed stability of improvement during follow-up, and were associated with simultaneous LV changes. Implications on all-cause mortality and AF might inform the care of heart failure patients being considered for advanced therapies, as well as the broader population of patients with heart failure and concomitant AF undergoing pharmacological unloading.

Indexed as

Atrial Function, LeftAtrial RemodelingHeart-Assist DevicesHeart AtriaHeart FailureVentricular Function, LeftAdultAgedAtrial FibrillationEchocardiographyFemaleHumansMaleMiddle AgedProspective StudiesStroke Volumeatrial fibrillationatrial remodelingheart assist deviceheart failureprognosis

Identifiers

PMID40357557
PMCPMC12263335

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