Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study

Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study

Abstract Impaired left atrial (LA) function in heart failure with preserved ejection fraction (HFpEF) is associated with adverse outcomes. A subgroup of HFpEF may have LA myopathy out of proportion to left ventricular (LV) dysfunction; therefore, we sought to characterize HFpEF patients with disprop...

Descripción completa

Guardado en:
Detalles Bibliográficos
Autores principales: Ravi B. Patel, Carolyn S. P. Lam, Sara Svedlund, Antti Saraste, Camilla Hage, Ru-San Tan, Lauren Beussink-Nelson, Jasper Tromp, Cynthia Sanchez, Joyce Njoroge, Stanley A. Swat, Ulrika Ljung Faxén, Maria Lagerstrom Fermer, Ashwin Venkateshvaran, Li-Ming Gan, Lars H. Lund, Sanjiv J. Shah
Formato: article
Lenguaje:EN
Publicado: Nature Portfolio 2021
Materias:
Medicine
R
Science
Q
Acceso en línea:https://doaj.org/article/e093b432c8384f01a9adf34cc50f376f
Etiquetas: Agregar Etiqueta
Sin Etiquetas, Sea el primero en etiquetar este registro!
id oai:doaj.org-article:e093b432c8384f01a9adf34cc50f376f
record_format dspace
spelling oai:doaj.org-article:e093b432c8384f01a9adf34cc50f376f2021-12-02T11:35:40ZDisproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study10.1038/s41598-021-84133-92045-2322https://doaj.org/article/e093b432c8384f01a9adf34cc50f376f2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-84133-9https://doaj.org/toc/2045-2322Abstract Impaired left atrial (LA) function in heart failure with preserved ejection fraction (HFpEF) is associated with adverse outcomes. A subgroup of HFpEF may have LA myopathy out of proportion to left ventricular (LV) dysfunction; therefore, we sought to characterize HFpEF patients with disproportionate LA myopathy. In the prospective, multicenter, Prevalence of Microvascular Dysfunction in HFpEF study, we defined disproportionate LA myopathy based on degree of LA reservoir strain abnormality in relation to LV myopathy (LV global longitudinal strain [GLS]) by calculating the residuals from a linear regression of LA reservoir strain and LV GLS. We evaluated associations of disproportionate LA myopathy with hemodynamics and performed a plasma proteomic analysis to identify proteins associated with disproportionate LA myopathy; proteins were validated in an independent sample. Disproportionate LA myopathy correlated with better LV diastolic function but was associated with lower stroke volume reserve after passive leg raise independent of atrial fibrillation (AF). Additionally, disproportionate LA myopathy was associated with higher pulmonary artery systolic pressure, higher pulmonary vascular resistance, and lower coronary flow reserve. Of 248 proteins, we identified and validated 5 proteins (involved in cardiomyocyte stretch, extracellular matrix remodeling, and inflammation) that were associated with disproportionate LA myopathy independent of AF. In HFpEF, LA myopathy may exist out of proportion to LV myopathy. Disproportionate LA myopathy is a distinct HFpEF subtype associated with worse hemodynamics and a distinct proteomic signature, independent of AF.Ravi B. PatelCarolyn S. P. LamSara SvedlundAntti SarasteCamilla HageRu-San TanLauren Beussink-NelsonJasper TrompCynthia SanchezJoyce NjorogeStanley A. SwatUlrika Ljung FaxénMaria Lagerstrom FermerAshwin VenkateshvaranLi-Ming GanLars H. LundSanjiv J. ShahNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Ravi B. Patel
Carolyn S. P. Lam
Sara Svedlund
Antti Saraste
Camilla Hage
Ru-San Tan
Lauren Beussink-Nelson
Jasper Tromp
Cynthia Sanchez
Joyce Njoroge
Stanley A. Swat
Ulrika Ljung Faxén
Maria Lagerstrom Fermer
Ashwin Venkateshvaran
Li-Ming Gan
Lars H. Lund
Sanjiv J. Shah
Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
description Abstract Impaired left atrial (LA) function in heart failure with preserved ejection fraction (HFpEF) is associated with adverse outcomes. A subgroup of HFpEF may have LA myopathy out of proportion to left ventricular (LV) dysfunction; therefore, we sought to characterize HFpEF patients with disproportionate LA myopathy. In the prospective, multicenter, Prevalence of Microvascular Dysfunction in HFpEF study, we defined disproportionate LA myopathy based on degree of LA reservoir strain abnormality in relation to LV myopathy (LV global longitudinal strain [GLS]) by calculating the residuals from a linear regression of LA reservoir strain and LV GLS. We evaluated associations of disproportionate LA myopathy with hemodynamics and performed a plasma proteomic analysis to identify proteins associated with disproportionate LA myopathy; proteins were validated in an independent sample. Disproportionate LA myopathy correlated with better LV diastolic function but was associated with lower stroke volume reserve after passive leg raise independent of atrial fibrillation (AF). Additionally, disproportionate LA myopathy was associated with higher pulmonary artery systolic pressure, higher pulmonary vascular resistance, and lower coronary flow reserve. Of 248 proteins, we identified and validated 5 proteins (involved in cardiomyocyte stretch, extracellular matrix remodeling, and inflammation) that were associated with disproportionate LA myopathy independent of AF. In HFpEF, LA myopathy may exist out of proportion to LV myopathy. Disproportionate LA myopathy is a distinct HFpEF subtype associated with worse hemodynamics and a distinct proteomic signature, independent of AF.
format article
author Ravi B. Patel
Carolyn S. P. Lam
Sara Svedlund
Antti Saraste
Camilla Hage
Ru-San Tan
Lauren Beussink-Nelson
Jasper Tromp
Cynthia Sanchez
Joyce Njoroge
Stanley A. Swat
Ulrika Ljung Faxén
Maria Lagerstrom Fermer
Ashwin Venkateshvaran
Li-Ming Gan
Lars H. Lund
Sanjiv J. Shah
author_facet Ravi B. Patel
Carolyn S. P. Lam
Sara Svedlund
Antti Saraste
Camilla Hage
Ru-San Tan
Lauren Beussink-Nelson
Jasper Tromp
Cynthia Sanchez
Joyce Njoroge
Stanley A. Swat
Ulrika Ljung Faxén
Maria Lagerstrom Fermer
Ashwin Venkateshvaran
Li-Ming Gan
Lars H. Lund
Sanjiv J. Shah
author_sort Ravi B. Patel
title Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
title_short Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
title_full Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
title_fullStr Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
title_full_unstemmed Disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the PROMIS-HFpEF study
title_sort disproportionate left atrial myopathy in heart failure with preserved ejection fraction among participants of the promis-hfpef study
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/e093b432c8384f01a9adf34cc50f376f
work_keys_str_mv AT ravibpatel disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT carolynsplam disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT sarasvedlund disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT anttisaraste disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT camillahage disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT rusantan disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT laurenbeussinknelson disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT jaspertromp disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT cynthiasanchez disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT joycenjoroge disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT stanleyaswat disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT ulrikaljungfaxen disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT marialagerstromfermer disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT ashwinvenkateshvaran disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT liminggan disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT larshlund disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
AT sanjivjshah disproportionateleftatrialmyopathyinheartfailurewithpreservedejectionfractionamongparticipantsofthepromishfpefstudy
_version_ 1718395853013516288

Ejemplares similares