Abstract 10944: Increased Left Atrial Volume Index Predicts Poor Prognosis In Heart Failure Patients With Preserved Ejection Fraction
Recently, it was reported that the prevalence of heart failure with preserved ejection fraction (HFpEF) has increased. They showed that the mortality of HFpEF was similar to that of patients with reduced ejection fraction. However, certain echocardiographic parameter predicting prognosis of HFpEF remains to be determined. We examined whether increased left atrial volume index (LAVI) can predict poor prognosis in patients with HFpEF. We performed transthoracic echocardiography in 97 consecutive patients with HFpEF (EF = 50%) hospitalized for heart failure (male/female=47/50, 75 ± 9 years old). LA volume was calculated by the biplane area-length Methods from apical 4- and 2-chamber views at end systolic phase. There were 34 cardiac events (35%) including cardiac death or rehospitalization for HF during a median follow-up period of 400 days (range 17 – 990 days). There were no significant differences in age, the prevalence of atrial fibrillation (AF), and EF between patients with and without cardiac events. However, LAVI was markedly higher in patients with cardiac events than in those without events (72 ± 32 vs. 42 ± 17 ml/m2, P<0.01). LAVI cut off value for predicting cardiac events was determined using the receiver operating characteristic (ROC) curve (>43 ml/m2). The Cox multivariate proportional hazard analysis revealed that high LAVI was an independent predictor for cardiac events (per 1 SD increase; hazard ratio, 2.598; 95% confidence interval, 1.175–5.907; P<0.05). Kaplan-Meier analysis showed that cardiac event rates were markedly higher in patients with high LAVI than in those with low LAVI (53% vs. 10%, P<0.01). In Conclusions, LAVI is a feasible parameter for poor prognosis in patients with HFpEF.
- © 2010 by American Heart Association, Inc.