Predictors of Subsequent Heart Failure After Left Atrial Appendage Closure

Dae Young Kim, Min Ji Kim, Jiwon Seo, Iksung Cho, Chi Young Shim, Geu Ru Hong, Jung Sun Kim, Jong Won Ha

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Background: Left atrial appendage occlusion (LAAO) plays an important role in preventing stroke in patients with atrial fibrillation. However, LAAO may interact unfavorably with left atrial (LA) compliance and reservoir function and thus increase the risk of heart failure (HF). The purpose of this study was to identify predictors of subsequent HF after successful LAAO. Methods and Results: A total of 98 patients (mean age 70±9 years, 68% male) who had undergone LAAO were included. The primary endpoint was unexpected HF admission after LAAO. During a mean period of 36±26 months, 16 of the 98 patients (16%) experienced hospital HF admission. In multivariate analysis, higher E/e’ (hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.02–1.20, P=0.014), higher left ventricular mass index (HR 1.02, 95% CI 1.00–1.03, P=0.023), history of HF (HR 4.78, 95% CI 1.55–14.7, P=0.006), and lower LA strain (HR 0.80, 95% CI 0.70–0.93, P=0.003) were independently associated with hospital HF admission. Patients with LAAO had a significantly higher incidence of subsequent HF than the control group after propensity score matching (P=0.046). Conclusions: LAAO increases the occurrence of HF, and it is not uncommon after successful LAAO. A previous history of HF, left ventricular mass index, E/e’, and abnormal LA strain are independently associated with the development of HF. These parameters should be considered before attempting LAAO.

Original languageEnglish
Pages (from-to)1129-1136
Number of pages8
JournalCirculation Journal
Volume86
Issue number7
DOIs
Publication statusPublished - 2022 Jul

Bibliographical note

Publisher Copyright:
© 2022 Japanese Circulation Society. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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