Abstract 18422: Association of Left Ventricular Geometry with Left Atrial Enlargement in Patients with Preserved Ejection Fraction
Background: Left ventricular (LV) hypertrophy is a known independent determinant of left atrial (LA) size. However, there is controversy regarding whether the LV geometric patterns are associated with LA enlargement (LAE).
Methods: We evaluated 47,865 patients with preserved ejection fraction to determine the relationship of LV geometry on LAE as determined by LA volume index (LAVi) ≥ 34 mL/m2.
Results: Abnormal LV geometry was identified in 42% of patients, with concentric remodeling (CR) being the most frequently observed abnormal LV geometric pattern (27%). LAE was indentified in 27% of patients with associated higher prevalence of abnormal LV geometry (58% vs. 37%, P<0.0001). Both LV mass index (LVMi) and relative wall thickness (RWT) were independent determinants of LAE (p<0.0001). LAVi and prevalence of LAE differ significantly by LV geometric patterns (p<0.0001), being greater in patients with CR, eccentric hypertrophy (EH) and concentric hypertrophy (CH) than those with normal LV geometry, and also in patients with EH and CH compared with CR (figure). Similarly, in multivariate analysis, compared to normal LV geometry, patients with CR, EH, and CH had progressively increasing independent associations with LAE; and compared to CR, both EH and CH were related to LAE. However, LAE was unrelated to the type of LVH.
Conclusion: LAE assessed as increased LAVi is strongly associated not only with LVMI but also with RWT. Furthermore, LAE was common in patients with abnormal LV geometry and was independently associated with CR, EH, and CH compared with normal LV geometry. However, LAE was unrelated to the type of LVH.
- © 2010 by American Heart Association, Inc.