Biatrial Remodeling in Patients with Cystic Fibrosis
Abstract
:1. Introduction
2. Methodology
2.1. Echocardiography
2.2. Assessment of Left Atrial Volumes and Strain
2.3. Right Ventricle and Atrium
2.4. D Assessment of Right Atrial Volumes and Function
2.5. Statistical Analysis
3. Results
3.1. Left and Right Ventricle
3.2. LA and RA Strain Parameters
3.3. Predictors of Mortality
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Controls (n = 32) | CF Survivors (n = 64) | CF Non-Survivors (n = 18) | p | |
---|---|---|---|---|
Age (years) | 36 ± 7 | 34 ± 11 | 34 ± 8 | 0.593 |
Female (%) | 12 (38) | 32 (50) | 12 (67) | 0.138 |
BMI (kg/m2) | 24.0 ± 3.3 | 19.9 ± 3.7 b | 18.1 ± 2.1 a,c | <0.001 |
Plasma glucose (mg/dL) | 87 ± 13 | 133 ± 28 b | 146 ± 35 d | 0.011 |
Diabetes (%) | 0 (0) | 27 (42) | 9 (50) | 0.372 |
Urea (mg/dL) | 26 ± 6 | 30 ± 7 | 44 ± 8 a,c | 0.007 |
Serum creatinine (mg/dL) | 0.87 ± 0.18 | 0.87 ± 0.28 | 1.33 ± 0.54 c,d | 0.066 |
FVC (%) | - | 63 ± 21 | 43 ± 17 | <0.001 |
FEV1 (%) | - | 45 ± 21 | 33 ± 13 | 0.033 |
MEF 25 (%) | - | 21 ± 11 | 14 ± 7 | 0.310 |
Controls (n = 32) | Cystic Fibrosis Survivors (n = 64) | Cystic Fibrosis Non-Survivors (n = 18) | p | |
---|---|---|---|---|
LV parameters | ||||
LV end-diastolic diameter (mm) | 46.6 ± 0.5 | 41.2 ± 0.5 b | 42.8 ± 0.6 d | <0.001 |
Interventricular septum thickness (mm) | 9.0 ± 1.2 | 9.2 ± 1.6 | 9.3 ± 2.0 | 0.819 |
Posterior wall thickness (mm) | 8.3 ± 1.9 | 8.9 ± 1.5 | 9.0 ± 2.0 | 0.300 |
Relative wall thickness | 0.36 ± 0.08 | 0.43 ± 0.09 b | 0.43 ± 0.1 a | <0.001 |
LV mass index (g/m2) | 71.7 ± 19.7 | 73.8 ± 21.5 | 84.1 ± 35.1 | 0.202 |
Ejection fraction (%) | 64 ± 6 | 63 ± 8 | 60 ± 11 | 0.257 |
E/A ratio | 1.7 ± 0.7 | 1.3 ± 0.4 b | 1.2 ± 0.3 a | <0.001 |
Deceleration time (ms) | 215 ± 74 | 198 ± 68 | 211 ± 65 | 0.543 |
E/e’ | 5.9 ± 1.4 | 7.0 ± 1.8 | 8.8 ± 3.1 a,c | <0.001 |
LV diastolic dysfunction (%) | 3 (9) | 7 (11) | 8 (44) a,e | 0.001 |
LA volume index (mL/m2) | 26.5 ± 5.3 | 26.6 ± 8.1 | 33.7 ± 10.5 a,e | 0.004 |
LA dilatation (%) | 1 (3) | 9 (14) | 10 (56) a,e | <0.001 |
RV parameters | ||||
RV basal diameter (mm) | 32.0 ± 4.6 | 29.9 ± 4.9 d | 29.6 ± 4.6 | 0.088 |
RV end-diastolic area (cm2) | 16 ± 4 | 14 ± 4 d | 13 ± 3.5 f | 0.048 |
RV end-systolic area (cm2) | 8.3 ± 2.5 | 7.6 ± 3.7 | 7.7 ± 3.6 | 0.686 |
Fractional area change (%) | 48 ± 8 | 45 ± 10 | 47 ± 8 | 0.598 |
s’ (cm/s) | 12.6 ± 1.4 | 11.6 ± 2.7 | 11.0 ± 1.5 | 0.191 |
TAPSE (mm) | 24 ± 4 | 20 ± 4 b | 19 ± 3 a | <0.001 |
RA volume index (mL/m2) | 21.2 ± 5.5 | 23.1 ± 9.0 d | 24.9 ± 11.8 e | 0.010 |
RA dilatation (%) | 5 (16) | 11 (17) | 7 (39) | 0.096 |
PAPs (mmHg) | 20 ± 7 | 31 ± 12 b | 35 ± 10 a | <0.001 |
Pulmonary hypertension (%) | 1 (3) | 5 (8) | 7 (39) a,e | <0.001 |
Controls (n = 32) | Cystic Fibrosis Survivors (n = 64) | Cystic Fibrosis Non-Survivors (n = 18) | p | |
---|---|---|---|---|
Global LA speckle tracking parameters | ||||
LA global strain (%) | 38 ± 8 | 34 ± 9 | 33 ± 12 | 0.301 |
LA positive strain (%) | 22 ± 8 | 19 ± 7 | 18 ± 8 | 0.228 |
LA negative strain (%) | 15 ± 3 | 15 ± 5 | 15 ± 5 | 0.981 |
LA early diastolic strain rate (cm/s) | 2.3 ± 0.7 | 1.9 ± 0.7 d | 1.7 ± 0.9 f | 0.047 |
LA late diastolic strain rate (cm/s) | 2.3 ± 0.7 | 2.2 ± 0.9 | 2.0 ± 0.7 | 0.633 |
LA systolic strain rate (cm/s) | 1.8 ± 0.4 | 1.9 ± 0.6 | 1.7 ± 0.5 | 0.638 |
4Ch LA speckle tracking parameters | ||||
LA global strain (%) | 38 ± 9 | 33 ± 10 d | 30 ± 12 f | 0.040 |
LA positive strain (%) | 23 ± 9 | 19 ± 8 d | 15 ± 7 a | 0.014 |
LA negative strain (%) | 15 ± 4 | 14 ± 6 | 15 ± 5 | 0.839 |
LA early diastolic strain rate (1/s) | 2.5 ± 0.8 | 1.9 ± 0.8 b | 1.6 ± 0.8 a | 0.002 |
LA late diastolic strain rate (1/s) | 2.1 ± 0.7 | 2.0 ± 0.9 | 1.9 ± 0.7 | 0.800 |
LA systolic strain rate (1/s) | 1.7 ± 0.4 | 1.8 ± 0.8 | 1.6 ± 0.6 | 0.570 |
2Ch LA speckle tracking parameters | ||||
LA global strain (%) | 35 ± 7 | 34 ± 10 | 36 ± 12 | 0.544 |
LA positive strain (%) | 20 ± 7 | 18 ± 8 | 21 ± 9.8 | 0.448 |
LA negative strain (%) | 15 ± 4 | 16 ± 6 | 15 ± 5 | 0.998 |
LA early diastolic strain rate (1/s) | 2.1 ± 0.7 | 1.8 ± 0.8 | 1.9 ± 0.9 | 0.398 |
LA late diastolic strain rate (1/s) | 2.4 ± 0.9 | 2.4 ± 1.0 | 2.3 ± 0.8 | 0.876 |
LA systolic strain rate (1/s) | 1.8 ± 0.5 | 1.9 ± 0.7 | 2.0 ± 0.6 | 0.831 |
Controls (n = 32) | Cystic Fibrosis Survivors (n = 64) | Cystic Fibrosis Non-Survivors (n = 18) | p | |
---|---|---|---|---|
RA global strain (%) | 38 ± 9 | 35 ± 13 | 35 ± 10 | 0.518 |
RA positive strain (%) | 24 ± 8 | 21 ± 10 | 19 ± 7 | 0.251 |
RA negative strain (%) | 14 ± 5 | 14 ± 6 | 16 ± 6 | 0.567 |
RA early diastolic strain rate (cm/s) | 1.9 ± 0.6 | 1.7 ± 0.7 | 1.6 ± 0.7 | 0.528 |
RA late diastolic strain rate (cm/s) | 2.1 ± 0.7 | 2.1 ± 0.9 | 2.6 ± 1.2 | 0.194 |
RA systolic strain rate (cm/s) | 2.1 ± 0.6 | 2.1 ± 0.7 | 2.3 ± 0.9 | 0.672 |
Univariate | |||
---|---|---|---|
OR | 95% CI | p | |
Age (years) | 0.52 | 0.17–1.50 | 0.215 |
BMI (kg/m2) | 0.83 | 0.67–1.00 | 0.056 |
FVC (%) | 0.94 | 0.91–0.98 | 0.001 |
FEV1 (%) | 0.96 | 0.93–0.99 | 0.042 |
LV mass index (g/m2) | 1.01 | 0.99–1.03 | 0.153 |
LAVI (mL/m2) | 1.09 | 1.02–1.16 | 0.008 |
LA longitudinal strain in 4Ch (%) | 0.97 | 0.92–1.03 | 0.362 |
LA early diastolic strain rate 4Ch (cm/s) | 0.59 | 0.28–1.24 | 0.161 |
LA positive strain 4Ch (%) | 0.95 | 0.88–1.02 | 0.149 |
TAPSE (mm) | 0.94 | 0.80–1.09 | 0.400 |
PAPs (mmHg) | 1.02 | 0.98–1.07 | 0.335 |
RAVI (mL/m2) | 1.10 | 1.02–1.18 | 0.020 |
RA longitudinal strain (%) | 0.99 | 0.95–1.05 | 0.808 |
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Dordevic, A.; Genger, M.; Schwarz, C.; Cuspidi, C.; Tahirovic, E.; Pieske, B.; Düngen, H.-D.; Tadic, M.
Biatrial Remodeling in Patients with Cystic Fibrosis
. J. Clin. Med. 2019, 8, 1141.
https://doi.org/10.3390/jcm8081141
Dordevic A, Genger M, Schwarz C, Cuspidi C, Tahirovic E, Pieske B, Düngen H-D, Tadic M.
Biatrial Remodeling in Patients with Cystic Fibrosis
. Journal of Clinical Medicine. 2019; 8(8):1141.
https://doi.org/10.3390/jcm8081141
Dordevic, Aleksandar, Martin Genger, Carsten Schwarz, Cesare Cuspidi, Elvis Tahirovic, Burkert Pieske, Hans-Dirk Düngen, and Marijana Tadic.
2019. "Biatrial Remodeling in Patients with Cystic Fibrosis
" Journal of Clinical Medicine 8, no. 8: 1141.
https://doi.org/10.3390/jcm8081141