Abstract 10592: Impact of Persistently Enlarged Left Atrial Volume Index on Cardiac Prognosis in Patients with Chronic Heart Failure
Background: It was reported that left atrial volume index (LAVI) is associated with the severity of diastolic dysfunction and poor prognosis in chronic heart failure (CHF). We also reported that high LAVI is an independent prognostic factor for CHF. However, LAVI may be altered by hemodynamic changes of patients. Therefore, we evaluated whether the persistently enlarged LAVI can predict poor prognosis in patients with CHF.
Methods and Results: Transthoracic echocardiography was performed in 185 consecutive patients (102 males, 83 females, mean age 74±11 years) who were hospitalized for heart failure at both admission and discharge. LA volume was calculated by modified biplane Simpson's method from apical 4- and 2-chamber views at end systolic phase. There were 76 cardiac events (41%) during a median follow-up period of 468 days. There were no significant differences in left ventricular end-diastolic dimensions and ejection fraction between patients with and without cardiac events. However, the ratio of LAVI changes (%ΔLAVI (LAVI admission - LAVI discharge) x 100 / LAVI discharge) was markedly lower in patients with cardiac events than in those without (15.3% vs. 3.6%, P < 0.03). Multivariate Cox proportional hazard analysis showed that the low %ΔLAVI was an independent predictor for cardiac events (hazard ratio 1.483 (per 1SD decrease); 95% confidence interval 1.037-2.113; P= 0.0239). Kaplan-Meier analysis also showed that %ΔLAVI could successfully risk stratify patients for cardiac events (Figure A). Furthermore, %ΔLAVI is a more powerful prognostic predictor in patients with small left atrial volume (Figure B).
Conclusion: Persistently enlarged LAVI was associated with cardiac events. %ΔLAVI may be a novel parameter for poor prognosis in patients with CHF.
- © 2011 by American Heart Association, Inc.