Abstract 16303: Left Atrial Ejection Fraction is a Feasible Parameter to Predict Poor Prognosis in Patients with Heart Failure and Sinus Rhythm
Decreasing left atrial (LA) systolic force was reported to be related to the occurrence of cardiac events. Recently, it was reported that decreased LA ejection fraction (LAEF) is a marker of left atrial dysfunction. However, the prognostic value of LAEF in patients with heart failure (HF) has not been fully investigated. We examined whether decreased LAEF can predict poor prognosis in patients with HF and sinus rhythm. We performed transthoracic echocardiography in 152 consecutive patients who were hospitalized for HF (88 males, 72 ± 13 years). Patients with atrial fibrillation and those with severe mitral valve diseases were excluded. LAEF was calculated by the biplane modified Simpson method from apical 4- and 2-chamber views at end systolic and diastolic phase. There were 57 cardiac events (38%) including cardiac deaths or rehospitalizations for worsening HF during a median follow-up period of 430 days (160 - 738 days). LAEF was markedly lower in patients with cardiac events than in those without. All patients were stratified into 3 groups according to tertiles for LAEF: > 38%, n=51; 29-37%, n=51; < 28%, n=50. Kaplan-Meier analysis showed that there was a stepwise increase in risk of cardiac events with each decrement of LAEF category (Figure). Multivariate Cox proportional hazard analysis showed that low LAEF was an independent predictor for cardiac events (hazard ratio 1.577; 95% confidence interval, 1.121-2.226; P<0.001). Furthermore, LAEF was an independent predictor even in patients without LA enlargement as well as in all patents. In conclusions, LAEF is a feasible parameter for poor prognosis in patients with HF. Further, LAEF can risk stratify patients without LA enlargement, who should have relatively good prognosis.
- © 2012 by American Heart Association, Inc.