The involvement of left atrial dysfunction in the occurrence of cardiovascular events in heart failure with preserved ejection fraction

Abstract

The left atrium is an essential compartment for left ventricular diastolic function. The volume of the left atrium and its size are incriminated in the occurrence of cardiovascular events in heart failure with impaired or preserved ejection fraction. However, few studies have evaluated its function in the occurrence of cardiovascular events. Evaluation of left atrial function in the occurrence of cardiovascular events in heart failure with preserved ejection fraction. This is a prospective study, carried out over 10 months, including 115 patients in sinus rhythm at the time of echocardiography, for whom an assessment of left atrial function was performed, excluding all patients with left and right ventricular systolic dysfunction. The three functions of the left atrium were assessed, namely, reservoir function, driving function and pump function. The cardiovascular events studied were mainly: diastolic dysfunction, rhythm disorders especially atrial fibrillation, stroke and death. Left atrial dysfunction was associated with older age, higher prevalence of atrial fibrillation and deterioration of left ventricular diastolic function and stroke. Diastolic dysfunction was the most frequent event encountered with recurrence in 62 patients (53.9%), followed by supraventricular rhythm disorder in 39% (45 patients). Atrial fibrillation was present in 73% of cases followed by variable conduction atrial flutter in 17% and atrial tachycardia in 10%. Stroke was found in 7 patients (6%) and death of unknown cause in one of our patients (0.8%). Left atrial dysfunction is associated with a high risk of cardiovascular events. It is necessary to assess the function of the left atrium once the diameter and volume of the left atrium is dilated.