Left atrial reservoir strain as a predictor of cardiac outcome in patients with heart failure: the HaFaC cohort study
Sjoerd Bouwmeester, Jonna A. van der Stam, Saskia L. M. van Loon, N.A.W. van Riel, Arjen‐Kars Boer, Lukas Dekker, Volkher Scharnhorst, Patrick Houthuizen
Abstract
Abstract Background The left atrium (LA) is a key player in the pathophysiology of systolic and diastolic heart failure (HF). Speckle tracking derived LA reservoir strain (LAS r ) can be used as a prognostic surrogate for elevated left ventricular filling pressure similar to NT-proBNP. The aim of the study is to investigate the correlation between LAS r and NT-proBNP and its prognostic value with regards to the composite endpoint of HF hospitalization and all-cause mortality within 1 year. Methods Outpatients, sent to the echocardiography core lab because of HF, were enrolled into this study. Patients underwent a transthoracic echocardiographic examination, commercially available software was used to measure LAS r . Blood samples were collected directly after the echocardiographic examination to determine NT-proBNP. Results We included 174 HF patients, 43% with reduced, 36% with mildly reduced, and 21% with preserved ejection fraction. The study population showed a strong inverse correlation between LAS r and log-transformed NT-proBNP (r = − 0.75, p < 0.01). Compared to NT-proBNP, LAS r predicts the endpoint with a comparable specificity (83% vs. 84%), however with a lower sensitivity (70% vs. 61%). Conclusion LAS r is inversely correlated with NT-proBNP and a good echocardiographic predictor for the composite endpoint of hospitalization and all-cause mortality in patients with HF. Trial registration : https://www.trialregister.nl/trial/7268