Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications
Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications(470 views) Palmiero G, Melillo E, Ferro A, Carlomagno G, Sordelli C, Ascione R, Monda V, Severino S, Ascione L, Caso P
Keywords: Functional Mitral Regurgitation
, Heart Failure With Reduced Ejection Fraction
, Left Atrial Function
, Left Ventricular Dysfunction, Aged
, Echocardiography, Doppler
, Female
, Heart Failure Diagnostic Imaging Physiopathology
, Hemodynamics
, Humans
, Middle Aged
, Mitral Valve Insufficiency Diagnostic Imaging Physiopathology
, Prognosis
, Severity Of Illness Index
, Stroke Volume
, Left Diagnostic Imaging Physiopathology,
Affiliations: *** IBB - CNR ***
Department of Cardiology, AORN Ospedali dei Colli-Monaldi, Naples, Italy.
Institute of Biostructure and Bioimaging, National Council of Research (CNR), Naples, Italy.
References: Not available.
Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications
AIMS: Functional mitral regurgitation (FMR) is a well-known pathophysiological factor in heart failure (HF) patients, and left atrial function (LAF) is a novel determinant of clinical status and outcome in this setting. However, little is known about the pathophysiological role of FMR on LAF in HFrEF patients. Aim of this study is to explore the possible interplay between the severity of FMR and LAF in heart failure with reduce ejection fraction (HFrEF) patients and their possible consequences. METHODS AND RESULTS: We studied 97 consecutive patients with FMR classified in two groups: mild-to-moderate MR ore less (FMR group, n = 38) and moderate-to-severe or more (SFMR group, n = 59). Using the phasic method, left atrial contractile, conduit, reservoir, and total emptying function (TLAEF) were calculated to assess LAF. SFMR group showed significantly lower values of LAF compared to FMR group. LA dysfunction (LA-dys) was defined for TLAEF values below the median and groups divided in four subgroups based on its presence. Patient with LA-Dys in SFMR group showed a worse clinical status, higher incidence of right ventricular dysfunction (RV-Dys), and pulmonary hypertension (PH), and a significant worse clinical survival compared to all other groups. CONCLUSION: In our study, the survival was significantly lower in SFMR/LA-Dys+ group. Furthermore, LA-Dys was strongly related with worse clinical status and higher incidence of PH and RV-Dys. These results suggest that in patients with SFMR and HFrEF, LA-Dys may represent both a marker of more advanced disease and a novel prognostic factor.
Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications
Significant functional mitral regurgitation affects left atrial function in heart failure patients: haemodynamic correlations and prognostic implications
Santulli G, Cipolletta E, Sorriento D, Del Giudice C, Anastasio A, Monaco S, Maione AS, Condorelli G, Puca A, Trimarco B, Illario M, Iaccarino G * CaMK4 gene deletion induces hypertension(429 views) J Am Heart Assoc Journal Of The American Heart Association (ISSN: 2047-9980), 2012; 1(4): N/D-N/D. Impact Factor:2.882 ViewExport to BibTeXExport to EndNote