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Article

Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study

by
Marco Alfonso Perrone
1,†,
Ferdinando Iellamo
1,†,
Valentino D’Antoni
2,
Alessandro Gismondi
2,
Deborah Di Biasio
2,
Sara Vadalà
2,
Giuseppe Marazzi
2,
Valentina Morsella
2,
Maurizio Volterrani
2,3 and
Giuseppe Caminiti
2,3,*
1
Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
2
Cardiology Rehabilitation Unit, IRCCS San Raffaele, 00163 Rome, Italy
3
Department of Human Science and Promotion of Quality of Life, San Raffaele Open University, 00163 Rome, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
J. Pers. Med. 2023, 13(8), 1272; https://doi.org/10.3390/jpm13081272
Submission received: 20 June 2023 / Revised: 9 August 2023 / Accepted: 14 August 2023 / Published: 18 August 2023
(This article belongs to the Special Issue Diagnosis, Treatment and Prognosis of Cardiovascular Diseases 2.0)
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Abstract

Background: the aim of this study was to assess acute changes in left atrial (LA) function during incremental aerobic exercise in patients with heart failure with mildly reduced ejection fraction (HFmrEF) in comparison to healthy subjects (HS). Methods: twenty patients with established HFmrEF were compared with 10 HS, age-matched controls. All subjects performed a stepwise exercise test on a cycle ergometer. Echocardiography was performed at baseline, during submaximal effort, at peak of exercise, and after 5 min of recovery. Results: HS obtained a higher value of METs at peak exercise than HFmrEF (7.4 vs. 5.6; between group p = 0.002). Heart rate and systolic blood pressure presented a greater increase in the HS group than in HFmrEF (between groups p = 0.006 and 0.003, respectively). In the HFmrEF group, peak atrial longitudinal strain (PALS) and conduit strain were both increased at submaximal exercise (p < 0.05 for both versus baseline) and remained constant at peak exercise. Peak atrial contraction strain (PACS) did not show significant changes during the exercise. In the HS group, PALS and PACS increased significantly at submaximal level (p < 0.05 for both versus baseline), but PALS returned near baseline values at peak exercise; conduit strain decreased progressively during the exercise in HS. Stroke volume (SV) increased in both groups at submaximal exercise; at peak exercise, SV remained constant in the HFmrEF, while it decreased in controls (between groups p = 0.002). Conclusions: patients with HFmrEF show a proper increase in LA reservoir function during incremental aerobic exercise that contributes to maintain SV throughout the physical effort.
Keywords: left atrial function; heart failure; stepwise exercise left atrial function; heart failure; stepwise exercise

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MDPI and ACS Style

Perrone, M.A.; Iellamo, F.; D’Antoni, V.; Gismondi, A.; Di Biasio, D.; Vadalà, S.; Marazzi, G.; Morsella, V.; Volterrani, M.; Caminiti, G. Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study. J. Pers. Med. 2023, 13, 1272. https://doi.org/10.3390/jpm13081272

AMA Style

Perrone MA, Iellamo F, D’Antoni V, Gismondi A, Di Biasio D, Vadalà S, Marazzi G, Morsella V, Volterrani M, Caminiti G. Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study. Journal of Personalized Medicine. 2023; 13(8):1272. https://doi.org/10.3390/jpm13081272

Chicago/Turabian Style

Perrone, Marco Alfonso, Ferdinando Iellamo, Valentino D’Antoni, Alessandro Gismondi, Deborah Di Biasio, Sara Vadalà, Giuseppe Marazzi, Valentina Morsella, Maurizio Volterrani, and Giuseppe Caminiti. 2023. "Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study" Journal of Personalized Medicine 13, no. 8: 1272. https://doi.org/10.3390/jpm13081272

APA Style

Perrone, M. A., Iellamo, F., D’Antoni, V., Gismondi, A., Di Biasio, D., Vadalà, S., Marazzi, G., Morsella, V., Volterrani, M., & Caminiti, G. (2023). Acute Changes on Left Atrial Function during Incremental Exercise in Patients with Heart Failure with Mildly Reduced Ejection Fraction: A Case-Control Study. Journal of Personalized Medicine, 13(8), 1272. https://doi.org/10.3390/jpm13081272

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