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Structure and functional predictors of left atrial pressure inpatients with end-stage heart failure
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Cardiology.ORCID iD: 0000-0003-3872-8964
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(English)Manuscript (preprint) (Other academic)
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:umu:diva-127266OAI: oai:DiVA.org:umu-127266DiVA: diva2:1044517
Available from: 2016-11-03 Created: 2016-11-03 Last updated: 2016-11-08
In thesis
1. Mechanical and histological disturbances in advanced heart failure and cardiac transplantation
Open this publication in new window or tab >>Mechanical and histological disturbances in advanced heart failure and cardiac transplantation
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The general purpose of this thesis is to establish capability and accuracy of speckle tracking echocardiography (STE) in assessing left atrial (LA), left ventricular (LV) and right ventricular (RV) function and their correlation with myocardial fibrosis, filling pressure and clinical outcomes in advanced heart failure (HF) patients before and after heart transplantation (HT).

I demonstrated that HT recipients had impaired LV twist dynamics in the form of reduced rotation twist angle and untwist rate but time to peak twist was not different from the age matched controls and other cardiac surgical patients.

With a longitudinal study conducted on patients with refractory HF, the best prognostic power has been shown by RV strain analysis. Among the indexes of LV function, the LV ejection fraction (LVEF) demonstrated the lowest diagnostic accuracy; instead LV global circumferential strain (GCS) showed a better sensitivity and specificity than LV global longitudinal strain (GLS).

When analyzing the relationship between different severity of myocardial fibrosis and LV cavity function, the strongest function parameter that correlated with severity of myocardial fibrosis was GLS. In contrast, none of diastolic LV function or even measures of exercise capacity correlated with myocardial fibrosis.

In patients with end-stage HF, global peak atrial longitudinal strain (PALS), an index of atrial reservoir function was dependent by pulmonary capillary wedge pressure (PCWP) and LV fibrosis, but not influenced by LV systolic function. Results from this study confirm previous evidence of correlation between impaired global PALS and increased PCWP.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2016. 99 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1862
Keyword
Advanced heart failure, heart transplantation, speckle tracking echocardiography, left ventricular function, right ventricular function, left ventricular fibrosis, left ventricular filling pressure, atrial strain
National Category
Cardiac and Cardiovascular Systems
Research subject
Cariology
Identifiers
urn:nbn:se:umu:diva-127295 (URN)978-91-7601-609-1 (ISBN)
Public defence
2016-11-30, E04, Målpunkt R-1, Norrlands Universitetssjukhus, Umeå, 13:00 (English)
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Supervisors
Available from: 2016-11-09 Created: 2016-11-05 Last updated: 2016-11-21Bibliographically approved

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Cameli, MatteoHenein, Michael
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