title: Left atrial changes in early stages of heart failure with preserved ejection fraction.
abstract: OBJECTIVE
  Increased left atrial (LA) mass was introduced as a compensatory mechanism in heart failure (HF) patients. Furthermore, atrial conduction time and LA emptying fraction is are deteriorated in HF with preserved ejection fraction (HFpEF). The aim of this study was to assess the early LA changes in HFpEF patients.
  
  
  METHODS
  In 79 consecutive patients with HFpEF (age 61±8 years, NYHA class I-III, LV EF ≥45%), a complete 2-dimensional, M-mode, and Doppler echocardiographic study was performed. According to the diastolic dysfunction (DD), patients were divided into three groups: Group I-29 healthy subjects (control group); Group II-HFpEF patients with mild DD; and Group III-HFpEF patients with moderate DD.
  
  
  RESULTS
  The LV mass was increased (P<.05), septal s', lateral s', septal and lateral MAPSE were decreased (P<.05, for all), E/e' ratio was increased (P<.001), LA mass and minimal volume were increased (P<.001, P<.05), LA emptying fraction was decreased (P<.05), and LA dyssynchrony was deteriorated (P<.05) in patients with mild DD compared to controls. These changes were of the same nature in patients with moderate LV DD.
  
  
  CONCLUSIONS
  In early stage of DD, in patients with HFpEF, in addition to LV hypertrophy and compromised LV longitudinal systolic function, the LA emptying fraction is reduced, LA mass and LAV min are increased and LA dyssynchrony is significant, despite normal LA dimensions. These findings suggest early LA function deterioration irrespective of normal cavity measurements, hence a need for optimum therapy.
authors.affiliation: Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Republic of Kosovo. i.bytyci@hotmail.com.
authors.forename: Ibadete
authors.initials: I
authors.lastname: Bytyçi
authors.affiliation: Clinic of Cardiology, University Clinical Centre of Kosova, Prishtina, Republic of Kosovo.|Medical Faculty, University of Prishtina, Prishtina, Republic of Kosovo.
authors.forename: Gani
authors.initials: G
authors.lastname: Bajraktari
mesh_terms: D016275:Atrial Function; D064752:Atrial Remodeling; D018450:Disease Progression; D042241:Early Diagnosis; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology*
keywords: diastolic dysfunction; heart failure; left atrial dyssynchrony; left atrial emptying fraction; left atrial mass