Evaluation of left atrial function in predicting severe cardiovascular events in patients with heart failure reduced ejection fraction at Hanoi Heart Hospital
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Abstract
Background: Left atrial (LA) dysfunction, as assessed by peak atrial longitudinal strain (LAGLS), has been associated with an increased risk of cardiovascular events and stroke in patients with heart failure with reduced ejection fraction (HFrEF). Objective: “To evaluate the predictive role of left atrial function in identifying major adverse cardiovascular events”. Methods: This was a cross-sectional descriptive study with longitudinal follow-up and comparative pre-post evaluation. A total of 56 inpatients with reduced ejection fraction (EF ≤ 40%), aged ≥ 18 years, and in sinus rhythm, admitted to Hanoi Heart Hospital from May 2023 to October 2024, were enrolled. Results: The mean age of participants was 61.75 ± 15.97 years; 66.1% were male. For each 1ml/m2 increase in left atrial volume, the risk of cardiovascular events increased by 8%, OR = 1.08 (CI: 1.01–1.06, p = 0.02). A 1% decrease in LAGLS was associated with a 1.6% increase in the risk of cardiovascular events, OR = 1.016 (CI: 0.29–1.95, p = 0.02). The area under the ROC curve (AUC) for LAGLS in predicting cardiovascular events was 0.612, with an optimal cut-off value of 15.25%, indicating its predictive significance. Similarly, each 1% decrease in LAGLS was associated with a 1.5% increase in stroke risk, OR= 1.015(CI: 0.04–6.32, p = 0.02), with an AUC of 0.602 at the same cut-off value of 15.25%, confirming its role in stroke prediction. Conclusion: Peak atrial longitudinal strain is a simple yet effective parameter for predicting major cardiovascular events in patients with heart failure with reduced ejection fraction.
Keywords
left atrial global longitudinal strain, cardiovascular events, stroke.
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References
2. Sargento L, Vicente Simões A, Longo S, Lousada N, Palma Dos Reis R. Left atrial function index predicts long-term survival in stable outpatients with systolic heart failure. Eur Heart J Cardiovasc Imaging. 2017;18(2):119-127. doi:10.1093/ehjci/jew196
3. Park JH, Hwang IC, Park JJ, Park JB, Cho GY. Prognostic power of left atrial strain in patients with acute heart failure. Eur Heart J Cardiovasc Imaging. 2021;22(2):210-219. doi:10.1093/ehjci/jeaa013
4. Chamberlain AM, Agarwal SK, Folsom AR, et al. A clinical risk score for atrial fibrillation in a biracial prospective cohort (from the Atherosclerosis Risk in Communities [ARIC] study). Am J Cardiol. 2011;107(1):85-91. doi:10.1016/j.amjcard.2010.08.049
5. Park JH. Two-dimensional Echocardiographic Assessment of Myocardial Strain: Important Echocardiographic Parameter Readily Useful in Clinical Field. Korean Circ J. 2019;49(10):908-931. doi:10.4070/kcj.2019.0200
6. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42(36):3599-3726. doi:10.1093/eurheartj/ehab368
7. Bosco E, Hsueh L, McConeghy KW, Gravenstein S, Saade E. Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review. BMC Med Res Methodol. 2021;21(1):241. doi:10.1186/s12874-021-01440-5
8. Left atrial stiffness index – an early marker of left ventricular diastolic dysfunction in patients with coronary heart disease | BMC Cardiovascular Disorders | Full Text. Accessed June 22, 2025. https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-024-04047-y
9. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1-39.e14. doi:10.1016/j.echo.2014.10.003
10. Park JH, Hwang IC, Park JJ, Park JB, Cho GY. Left Atrial Strain to Predict Stroke in Patients With Acute Heart Failure and Sinus Rhythm. J Am Heart Assoc. 2021;10(13):e020414. doi:10.1161/JAHA.120.020414
11. Khánh NB, Hoài NTT, Hương ĐTT, Ngọc ĐB, Hùng NM. Chức năng nhĩ trái trên siêu âm đánh dấu mô ở bệnh nhân suy tim mạn tính có phân suât tống máu giảm. VMJ. 2022;520(2). doi:10.51298/vmj.v520i2.4162
12. Chiến ĐV, Đăng LH. Đặc điểm siêu âm tim đánh dấu mô nhĩ trái ở bệnh nhân suy tim có phân suất tống máu EF > 40%. Journal of 108 - Clinical Medicine and Phamarcy. Published online August 27, 2022. doi:10.52389/ydls.v17i6.1379
13. Left Atrial Function Predicts Cardiovascular Events in Patients With Chronic Heart Failure With Reduced Ejection Fraction - PubMed. Accessed May 14, 2025. https://pubmed.ncbi.nlm.nih.gov/30316541/
14. Huang YT, Tseng YT, Chu TW, et al. N-terminal pro b-type natriuretic peptide (NT-pro-BNP) -based score can predict in-hospital mortality in patients with heart failure. Sci Rep. 2016;6:29590. doi:10.1038/srep29590
15. Januzzi JL, van Kimmenade R, Lainchbury J, et al. NT-proBNP testing for diagnosis and short-term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT-proBNP Study. Eur Heart J. 2006;27(3):330-337. doi:10.1093/eurheartj/ehi631
16. Lupón J, de Antonio M, Vila J, et al. Development of a novel heart failure risk tool: the barcelona bio-heart failure risk calculator (BCN bio-HF calculator). PLoS One. 2014;9(1):e85466. doi:10.1371/journal.pone.0085466
17. Miró Ò, Rossello X, Gil V, et al. Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department: A Cohort Study. Ann Intern Med. 2017;167(10):698-705. doi:10.7326/M16-2726
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