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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Imaging
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1501004

Evaluation of Left Atrial Function and the Relationship Between Left Atrial Stiffness Index and Exercise Capacity in Hypertension-related Heart Failure with Preserved Ejection Fraction

Provisionally accepted
Qingfeng Zhang Qingfeng Zhang 1,2Sijia Wang Sijia Wang 1,2Hongmei Zhang Hongmei Zhang 2Kai Wang Kai Wang 3Geqi Ding Geqi Ding 2Luwei Ye Luwei Ye 2Wenhua Li Wenhua Li 2Chunmei Li Chunmei Li 2Yan Deng Yan Deng 2YI WANG YI WANG 2Lixue Yin Lixue Yin 1,2*
  • 1 School of Medicine,, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
  • 2 Key Laboratory in Cardiac Electrophysiology and Biomechanics, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
  • 3 Department of Acute Care Surgery,, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China

The final, formatted version of the article will be published soon.

    The left atrial stiffness index (LASI) holds significance in the atrioventricular coupling function and heart failure progression. To assess left atrial function and evaluate the relationship between LASI and exercise capacity in hypertensionrelated heart failure with preserved ejection fraction (HT-HFpEF). Methods: The study involved 62 healthy subjects and 163 patients with HT (112 patients in simple HT group and 51 patients in HT-HFpEF group). Each patient performed exercise stress test and standard ultrasonic images were evaluated. A comprehensive evaluation of atrioventricular function, along with investigation into the correlation between these functional parameters and exercise capacity. And further to investigate the feasibility of predicting exercise intolerance using threedimensional derived left atrial strain index (LASI) (E/e'/LASr and E/e'/LASr-c). Results: Compared to healthy subjects, HT group demonstrated the elevation in left atrial volume accompanied by decrease in strain value (P < 0.05). In HT-HFpEF group, further significant reductions were observed in both longitudinal (LASr) and circumferential strain (LASr-c, LASct-c) (P < 0.05). Univariate regression demonstrated that both E/e'/LASr and E/e'/LASrc were significantly correlated with metabolic equivalents (METs) (r = -0.462, P < 0.001; r = -0.381, P < 0.001). The E/e'/LASr demonstrates comparable diagnostic efficacy to exercise-E/e' in assessing exercise intolerance in HT-HFpEF patients (AUC: 0.836 vs 0.867, P=0.239). Conclusion: Progressive LA remodeling contributes to decreased atrioventricular compliance in HT and HT-HFpEF patients.E/e'/LASr serves as an independent indicator of exercise intolerance in patients with HT-HFpEF.

    Keywords: three-dimensional speckle tracking, Left atrial, Hypertension, stiffness, heart faliure

    Received: 24 Sep 2024; Accepted: 03 Dec 2024.

    Copyright: © 2024 Zhang, Wang, Zhang, Wang, Ding, Ye, Li, Li, Deng, WANG and Yin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lixue Yin, School of Medicine,, University of Electronic Science and Technology of China, Chengdu, 611731, Sichuan Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.