Left Atrial Reverse Remodeling in Patients Supported With Durable Left Ventricular Assist Devices and Clinical Implications

• DOI: 10.1161/circheartfailure.125.012807
• Publication Date: 2025-05-13T09:00:21Z
• Authors: Christos P. Kyria...; Konstantinos Sideris; Iosif Taleb; Eleni Maneta; Eleni Tseliou; Jake Aadland; Andrew S. Baird; Michael J. Bonios; Marisca Nelson; Elizabeth Dranow; Matthew L. Goodwin; Thomas C. Hanff; Spencer Carter; Craig H. Selzman; Josef Stehlik; Omar Wever-Pinzon; Satvik Ramakrishna; Ethan Tumarkin; Stavros G. Drakos
• Keywords: Ventricular remodeling; Ischemic Cardiomyopathy

BACKGROUND: The left atrium (LA) maintains a dynamic interaction with the ventricular (LV). LA forward and reverse remodeling affect prognosis in patients chronic heart failure. We examined supported LV assist devices (LVADs) investigated potential impact on clinical outcomes. METHODS: Consecutive advanced failure receiving durable, continuous-flow LVADs were prospectively evaluated (n=263). After excluding unavailable echocardiographic data, 241 studied. Echocardiographic assessment was performed pre- serially post-LVAD implantation. assessed structure function their association, of all-cause mortality, LVAD-related adverse events, atrial fibrillation (AF). RESULTS: Most male, white, mean age 56±15 years. Forty-four percent had underlying ischemic cardiomyopathy; 65% Interagency Registry for Mechanically Assisted Circulatory Support profile 1 to 3, ejection fraction 19±7%, end-diastolic diameter 6.7±1.1 cm pre-LVAD. improved by month LVAD support remained 12 months, as evidenced volumes, emptying fractions, strain parameters. changes shown be associated structural functional changes. magnitude but not cerebrovascular accident/transient attack, thrombosis, or late right rates months support. Of 46 AF pre-LVAD, 28 (61%) converted sinus rhythm, 18 (39%) during serial assessment. CONCLUSIONS: early support, showed stability improvement follow-up, simultaneous Implications mortality might inform care being considered therapies, well broader population concomitant undergoing pharmacological unloading.