Table 2.
Clinical characteristics of included studies
| Author/year | Study design | Study setting | Heart failure phenotype examined | LVEF cutoff | Number of patients (n) | Age (years) | Female sex (%) | Atrial fibrillation (%) | Diabetes mellitus (%) | Hypertension (%) | Ischemic heart disease (%) | BMI (kg/m2) | Moderate to severe mitral regurgitation | LA structure and functional parameters measured |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Hoshida et al. [27] | Prospective multi-center observational study | CHF, inpatient setting | HFpEF | ≥ 50% | 105 | 78.5 ± 10.2 | 53.3% | 41% | 88% | 24.3 ± 5.0 | LAVi, E/e' | |||
| Harada et al. [28] | Prospective single-center cohort study | AHF, compensatory inpatient setting | HFpEF | ≥ 45% | 92 | 73.0 ± 12.8 | 59% | 47% | 27% | 72% | 34% | 22.3 ± 3.6 | LAVi, E/e', e' | |
| Hwang et al. [29] | Prospective multi-center observational study | AHF, multi-center, inpatient setting | HFpEF | ≥ 50% | 1105 | 76.0 ± 9.6 | 60.6% | 32.9% | 32.4% | 64.3% | 29.3% | 23.9 ± 3.7 | LAVi, E/e' LA reservoir strain | |
| Shah et al. [30] | Retrospective cohort study | CHF, inpatient setting | HFrEF | ≤ 40% | 67 | 49.5 ± 11.4 | 34.3% | 9% | 64.2% | 35.8% | 31.8 ± 7.0 | LAVi, E/e' | ||
| HFrEF | ≤ 40% | 69 | 57.5 ± 15.3 | 24.6% | 8.7% | 60.9% | 36.2% | 31.1 ± 7.3 | LAVi, E/e' | |||||
| Tanaka et al. [31] | Retrospective cohort study | CHF, outpatient setting | HFrEF | ≤ 45% | 205 | 59 ± 17 | 31% | 14% | 27% | 19% | 32% | LAVi, E/e' | ||
| Castrichini et al. [32] | Prospective single-center cohort study | CHF, outpatient setting | HFrEF | < 40% | 77 | 65 ± 11 | 12.1% | 37.7% | 45.5% | 54.5% | 40.3% | 32% | LAVi, E/e', LA reservoir strain | |
| Valentim et al. [33] | Prospective single-center cohort study | CHF, outpatient setting | HFrEF | < 40% | 42 | 58.6 ± 11.1 | 17.1% | 40% | 31.4% | 42.9% | 28.1 ± 3.8 | LAVi, E/e' | ||
| Kurzawski et al. [34] | Retrospective single-center cohort | CHF, inpatient and outpatient settings | HFrEF | < 25% | 63 | 61.9 ± 10.9 | 4.8% | 33.3% | 54% | 52.4% | 26.2 ± 4.5 | LAVi, E/e', LA reservoir strain | ||
| Park et al. [16] | Retrospective cohort study | AHF, multi-center, inpatient setting | HFpEF | ≥ 50% | 1191 | 73.4 ± 13.3 | 60.3% | 35% | 31% | 62% | 27.4% | 23.8 ± 4.1 | LAVi, E/e', LA reservoir strain, e' | |
| HFrEF | < 40% | 2036 | 68.4 ± 14.1 | 38.3% | 24.9% | 36.3% | 54.2% | 34.4% | 23.1 ± 4.3 | |||||
| Deferm et al. [35] | Prospective single-center cohort study | ADHF (Acute decompensated HF), inpatient setting | HFrEF | ≤ 40% | 31 | 64 ± 15 | 22.6% | 32.3% | 29% | 48.4% | 48.4% | 28.1 ± 6.0 | 51.6% | LAVi, E/e' LA reservoir strain |
| Shah et al. [36] | Randomized, multi-center double-blind placebo controlled trial | CHF, multi-centers (752 sites in 43 countries), inpatients and outpatient settings | HFpEF (PARAGON-HF trial-ECHO study | ≥ 45% | 1097 | 74 ± 8 | 53% | 35% | 40% | 94% | 30% | 29.9 ± 4.9 | 12% | LAVi, E/e', E/A, e' |
| Reddy et al. [14] | Prospective single-center cohort study | CHF, single-center, outpatient setting | HFpEF | ≥ 50% | 238 | 68 ± 10 | 62% | 17% | 29% | 90% | 32% | 32.9 ± 7.1 | LAVi, LA Reservoir, conduit and contractile strain | |
| Modin et al. [18] | Retrospective single-center cohort study | CHF, outpatient setting | HFrEF | ≤ 45% | 818 | 66.4 ± 11.4 | 26.6% | 15.3% | 11.4% | 41.2% | 55.9% | 26.4 ± 4.8 | 9% | LAVi, E/e', E/A, e' |
| Shintani et al. [37] | Retrospective single-center cross-sectional study | AHF, inpatient setting | HFpEF | ≥ 50% | 127 | 80.6 ± 8.1 | 50% | 52% | 41% | 67% | 23.2 ± 3.7 | LAVi | ||
| HFrEF | < 40% | 617 | 75.0 ± 11.1 | 33% | 48% | 37% | 71% | 22.5 ± 3.7 | ||||||
| Wu et al. [38] | Prospective single-center cohort study | CHF, inpatient setting | HFpEF | ≥ 50% | 163 | 61.1 ± 15.3 | 61% | 30.1% | 60.1% | 3.5% | 25.9 ± 4.2 | LAVi, E/e', E/A, e' | ||
| HFrEF | < 40% | 34 | 54.5 ± 15.4 | 18% | 17.6% | 44.1% | 44.1% | 25.2 ± 4.7 | ||||||
| Telles et al. [39] | Prospective single-center cohort study | CHF, inpatient setting | HFpEF | ≥ 50% | 49 | 69.4 ± 8.0 | 71.4% | 26.5% | 14% | 67% | 14% | 30.2 ± 5.0 | LAVi, E/e', LA reservoir strain, conduit, e', E/A | |
| Sobirin et al. [40] | A single-center, unblind, randomized, controlled clinical trial | CHF, outpatient setting | HFpEF | > 50% | 30 | 62 ± 8 | 50% | 73.3% | LAVi, E/e' | |||||
| Lundberg et al. [41] | Prospective single-center cohort study | CHF, inpatient setting | HFpEF | ≥ 50% | 92 | 73.0 ± 8.8 | 62% | 48% | 19% | 69% | 3% | 26.6 ± 5.2 | LAVi, E/e', LA reservoir strain, e', E/A | |
| HFrEF | < 50% | 72 | 56.3 ± 12.6 | 21% | 46% | 18% | 58% | 26% | 27.3 ± 5.2 | |||||
| Saikhan et al. [42] | Prospective single-center cohort study | CHF, outpatient setting | HFpEF | ≥ 50% | 110 | 63 ± 11 | 38.1% | excluded | 48.1% | 82.7% | 60% | 27.8 ± 5.4 | LAVi, LA Reservoir, conduit and contractile strain | |
| Burns [43] | Prospective single-center cohort study | CHF, outpatient setting | HFpEF with anemia | ≥ 50% | 224 | 65 ± 12 | 56% | 26% | 37% | 79% | 50% | 32 ± 10 | LAVi, E/e', e' | |
| HFpEF without anemia | ≥ 50% | 195 | 63 ± 13 | 69% | 27% | 28% | 75% | 46% | 33 ± 9 | |||||
| Obokata et al. [44] | Prospective single-center cohort study | CHF, inpatient and outpatient settings | HFpEF | ≥ 50% | 271 | 71 ± 9 | 56% | 42% | 33% | 84% | 57% | 32 ± 7 | LAVi, E/e', e' | |
| Nagy et al. [45] | Subset of prospective, observational, multi-center study | CHF, inpatient setting | HFpEF | ≥ 45% | 86 | 72 ± 10 | 51% | 60% | 33% | 79% | 15% | 30 ± 5 | LAVi, E/e', LA reservoir strain, e, E/A ratio' | |
| Carluccio et al. [19] | Prospective single-center cohort study | CHF, outpatient setting | HFrEF | ≤ 40% | 405 | 65.2 ± 12.3 | 24% | 26% | 38% | 26.6 ± 4.1 | LAVi, E/e', LA reservoir strain, e, E/A ratio' | |||
| Malagoli et al. [46] | Prospective single-center cohort | CHF, outpatient setting | HFrEF | < 40% | 286 | 67 ± 11 | 19% | 64% | LAVi, LA Reservoir strain | |||||
| Eroglu et al. [47] | Retrospective cohort | CHF, outpatient setting | HFrEF | < 50% | 59 | 57 ± 13 | 23% | 84% | LAVi, E/e', E/A, e' | |||||
| Almeida et al. [48] | Retrospective case–control study | AHF, inpatient setting | HFpEF | ≥ 50% | 65 | 55% | 47.7% | 80% | 33.8% | LAVi, E/e' | ||||
| HFrEF | < 40% | 65 | 43.1% | 70.8% | 44.6% | |||||||||
| Liu et al. [49] | Prospective single-center study | CHF, inpatient setting | HFpEF | ≥ 50% | 55 | 61 ± 13 | 54.5% | 43% | 93% | 33% | LAVi, E/e', LA reservoir strain, e', E/A | |||
| Shah et al. [50] | Prospective multinational multi-center observational study | CHF, outpatient setting | HFpEF | ≥ 40% | 51 | 72.4 ± 9.0 | 63% | 35% | 25% | 92% | 16% | 32.5 ± 10.7 | LAVi, E/e', LA reservoir strain | |
| CHF, outpatient setting | HFpEF | ≥ 40% | 151 | 74.7 ± 8.7 | 52% | 58% | 30% | 81% | 21% | 29.0 ± 8.5 | LAVi, E/e', LA reservoir strain | |||
| Xu et al. [51] | Retrospective, single-center cohort | CHF, inpatient setting | HFrEF | < 40% | 28 | 38 ± 14 | 18% | 20.6 ± 3.2 | 57.1% | |||||
| CHF, inpatient setting | HFrEF | < 40% | 17 | 42 ± 10 | 41% | 22.5 ± 5.2 | 17.6% | |||||||
| Saha et al. [52] | Retrospective, single-center cohort | CHF, outpatient setting | HFrEF | < 40% | 49 | 72 ± 13 | 42% | 8% | 12% | 68% | E/e', LA reservoir strain | |||
| Abohammar et al. [53] | Prospective single-center observational study | AHF, inpatient setting | HFpEF | > 50% | 114 | 59 ± 8 | 55% | 64% | 64% | 16% | 27 ± 3 | LAVi, E/e' | ||
| Modin et al. [54] | Retrospective single-center cohort | CHF, outpatient setting | HFrEF | < 45% | 151 | 70.5 ± 9.2 | 21.2% | 9.2% | 43% | 26.7 ± 5.1 | LAVi, E/e' | |||
| Batalli [55] | Prospective single-center cohort | CHF | HFpEF | NA | 55 | 63.0 ± 6.8 | Excluded | 59% | 41% | 29 ± 4 | E/e' | |||
| HFrEF | NA | 56 | 62 ± 12 | Excluded | 38% | 45% | 28.0 ± 3.6 | |||||||
| Sugimoto et al. [56] | Prospective single-center study | CHF, outpatient setting | HFpEF | > 50% | 20 | 72.6 ± 10.3 | 60% | 42% | 74% | 10% | 28.3 ± 5.0 | LAVi, E/e', LA reservoir strain, E/A | ||
| HFrEF | < 40% | 49 | 63.1 ± 12.9 | 31% | 35% | 63% | 52% | 26.7 ± 4.5 | ||||||
| Hage et al. [57] | Subset of prospective observational multicenter study | AHF, inpatient setting | HFpEF | > 45% | 86 | 72.3 ± 8.9 | 51% | 57% | 31% | 79% | 34% | 28.8 ± 5.9 | LAVi, E/e' | |
| Sargento et al. [58] | Prospective single-center observational study | CHF, outpatient setting | HFrEF | < 40% | 203 | 67.8 ± 12.5 | 26.6% | 26.1% | 32% | 88.7% | 39.4% | 27.2 ± 4.4 | LAVi | |
| Aung et al. [59] | Prospective two center study | CHF | HFpEF | ≥ 50% | 38 | 65.2 ± 5.7 | 50% | 13.2% | 60.5% | 47.4% | 28.1 ± 2.0 | LAVi, E/e', LA reservoir strain, contractile, e' | ||
| Hung [60] | Prospective single-center cohort study | CHF, outpatient setting | HFpEF | ≥ 50% | 58 | 64.3 ± 12.4 | 53.4% | 32.8% | 74.1% | 27.2 ± 3.7 | E/e', LA reservoir strain, e', E/A | |||
| Freed et al. [61] | Prospective single-center cohort study | CHF, outpatient setting | HFpEF | ≥ 50% | 308 | 65 ± 13 | 64% | 26% | 30% | 75% | 50% | 31.5 ± 8.6 | 14% | LAVi, LA Reservoir, conduit and contractile strain, E/e', E/A |
| Unger et al. [62] | Prospective single-center cohort | CHF, outpatient setting | HFpEF without CKD | > 50% | 154 | 60.9 ± 12.3 | 62% | 22% | 21% | 68% | 46% | 31.8 ± 8.7 | LAVi, E/e', LA reservoir, conduit and booster strain | |
| HFpEF with CKD | > 50% | 145 | 69.3 ± 12.1 | 66% | 30% | 39% | 83% | 52% | 31.5 ± 8.4 | LAVi, E/e', LA reservoir, conduit and booster strain | ||||
| Georgievska-Ismail et al. [63] | Prospective single-center, cross-sectional study | CHF, outpatient setting | HFpEF | > 50% | 108 | 63.2 ± 8.9 | 60.2% | 98.1% | 18.5% | 29.9 ± 3.8 | ||||
| Melenovsky et al. [17] | Retrospective single-center cohort study | CHF, outpatient setting | HFpEF | ≥ 50% | 101 | 71 ± 10 | 58% | 42% | 47% | 93% | 44% | 34.0 ± 8.6 | LAVi,e' | |
| HFrEF | < 50% | 97 | 61 ± 13 | 20% | 26% | 41% | 56% | 46% | 31.0 ± 6.9 | |||||
| Gracia et al. [64] | Prospective single-center cohort study | CHF, outpatient setting | HFpEF | ≥ 50% | 28 | 60 ± 2 | 40% | 90% | LAVi, E/e', E/A, e' | |||||
| Hasselberg et al. [65] | Prospective single-center Cross-sectional study | CHF, inpatient setting | HFpEF | ≥ 50% | 37 | 58 ± 11 | 32.4% | 14% | 41% | 60% | 26 ± 4 | LAVi, E/e', E/A, e' | ||
| Sanchis et al. [15] | Prospective single-center cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 63 | 76 ± 8 | 71.4% | 39.7% | 23.8% | 85.7% | 30 ± 5 | LAVI, E/e', LA reservoir strain | ||
| Shah et al. [66] | International, multicenter, randomized, double blind placebo-controlled trial (with an echo substudy) | CHF, multi-center (270 sites in 6 countries) | HFpEF (TOPCAT-ECHO) | ≥ 45% | 935 | 69.9 ± 9.7 | 49% | 38% | 40% | 91% | 60% | 32.6 ± 7.5 | LAVi, E/e', LA reservoir, contractile strain, E/A, e' | |
| Santos et al. [67] | Echo substudy multicenter, international, randomized, double blind placebo-controlled trial | CHF, multi-centers (65 centers in 13 countries) | HFpEF (PARAMOUNT trial) | ≥ 45% | 135 | 70 ± 9 | 61% | 23% | 35% | 92% | 22% | 29.6 ± 5.7 | LAVi, LA Reservoir, conduit and contractile strain, E/e', E/A | |
| HFrEF | < 40% | 32 | 74 ± 12 | 37.5% | 50% | 43.8% | 78.1% | |||||||
| Donal et al. [68] | Prospective, multi-center international observational study | AHF inpatient setting | HFpEF | ≥ 45% | 539 | 77 ± 19 | 56% | 30% | 78% | 43.5% | 29 ± 6 | LAVi, E/e', E/A, e' | ||
| Burke et al. [69] | Prospective single-center cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 419 | 65 ± 13 | 62% | 26% | 33% | 77% | 48% | 33 ± 9 | 14% | LAVi, E/e', e' |
| Motoki et al. [70] | Prospective single-center cohort | CHF, outpatient setting | HFrEF | ≤ 35% | 108 | 57 ± 15 | 23% | excluded | 27% | 51% | 45% | LAVi, E/e', LA reservoir strain, contractile, e' | ||
| Obokata et al. [71] | Prospective single-center cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 40 | 77 ± 13 | 65% | 35% | 88% | 22 ± 5 | LA reservoir strain, E/e', e', E/A | |||
| Carluccio et al. [72] | Prospective single-center observational study | CHF, outpatient setting | HFrEF | < 45% | 747 | 68 ± 12 | 22% | 16% | 22% | 48% | 26 ± 4 | 32% | LAVi, E/e' | |
| Gupta et al. [73] | Prospective on-going multi-comunities cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 85 | 61.6 ± 6.9 | 85% | 42% | 85% | 13% | 32.6 ± 5.9 | 0% | E/A | |
| HFrEF | < 50% | 31 | 60.9 ± 8.0 | 65% | 68% | 84% | 32% | 33.7 ± 9.6 | 10% | |||||
| Oh et al. [23] | International randomized trial | CHF, international (122 sites in 26 countries) | HFrEF | ≤ 35% | 2006 | 60.9 ± 9.5 | 13.6% | 5% | 37% | 60% | 99% | 24% | LAVi, E/e', E/A, e' | |
| Zile et al. [74] | Echo-cohort of placebo-controlled double-blind multi-center international parallel study | CHF, inpatient and outpatient settings | HFpEF (I-PRESERVE-Echo cohort) | ≥ 45% | 745 | 72 ± 7 | 62% | 26% | 25% | 92% | 33% | 30 ± 5 | E/e', LA area, e' | |
| Tan et al. [75] | Prospective single-center cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 50 | 72 ± 8 | 70% | excluded | 30% | 100% | 18% | 31 ± 5 | LAVi | |
| Jaubert et al. [76] | Prospective single-center cohort | CHF, inpatient setting | HFpEF | ≥ 45% | 59 | 64 ± 12 | 37% | 36% | 58% | 49% | 27 ± 5 | LAVi, E/e', e' | ||
| Hinderliter et al. [77] | Prospective cohort | CHF, outpatient setting | HFrEF | ≤ 40% | 211 | 57 ± 12 | 31% | 19% | 44% | 77% | 43% | 31.2 ± 7.2 | LAVi | |
| Donal et al. [78] | Prospective multi-center cohort | CHF, outpatient setting | HFrEF | < 35% | 75 | 59 ± 11 | 82.7% | 34.7% | LAVi | |||||
| Jasic-Szpak et al. [79] | Prospective single-center cohort | CHF, outpatient setting | HFpEF without AF | ≥ 50% | 131 | 63.7 ± 8.0 | 73% | 0 | 37% | 89% | - | 29.4 ± 4.1 | - | LAVi, LA Reservoir, conduit and contractile strain, E/e', E/A |
| Prospective single-center cohort | CHF, outpatient setting | HFpEF with AF | ≥ 50% | 39 | 67.4 ± 8.9 | 72% | 100% | 49% | 97% | - | 30.4 ± 4.3 | - | ||
| CarluccioE [80] | Prospective single-center cohort | CHF, outpatient setting | HFpEF | ≥ 50% | 46 | 75 ± 8 | 52% | - | 35% | 91% | - | LAVi, E/e', E/A |
ADHF acute decompensated heart failure, AHF acute heart failure, CHF chronic heart failure, CKD chronic kidney disease, HFpEF heart failure with preserved ejection fraction, HFrEF heart failure with reduced ejection fraction, LA left atrial, LAVi left atrial volume index, e’ mitral annular early diastolic velocity by tissue doppler, E/A the ratio between early and late mitral inflow velocity by doppler, E/e’ the ratio between early mitral inflow velocity and mitral annular early diastolic velocity