Abstract 17614: Left Atrial Volume Index Predicts Mortality in Patients with Doppler Derived Normal Left Ventricular Diastolic Function and Preserved Ejection Fraction

Abstract

Background: Left atrial (LA) enlargement (LAE) predicts cardiovascular morbidity and mortality, but it is still unknown whether the LAE predicts mortality in large cohort of patients with Doppler derived normal left ventricular (LV) diastolic function and preserved ejection fraction.

Methods: We evaluated 6,943(age: 57±14; 43% male) patients with normal LV diastolic function (using Doppler echocardiographic parameters) and preserved left ventricular ejection fraction (LVEF > 50%) to determine the impact of LA volume index (LAVi) on mortality during an average follow-up of 2.3±1.0 years.

Results: Deceased patients (n=251; age 64±15 years; 55% male) had significantly higher LAVi (29.9 vs. 26.2, p<0.0001) and LAE (51.4% vs.35.8%, p<0.0001) than surviving patients (n=6,692; age: 57±14; 43% male). After adjusting for covariates, LAVi was an independent predictor of mortality [HR: 1.03 (1.02-1.05), p<0.0001]. Similarly, moderate [LAVi (34-39 ml/m2) HR: 1.85 (1.28-2.67), p=0.001] and severe [LAVi (≥ 40ml/m2) HR: 2.41 (1.57-3.70), p<0.0001] LAE (Figure) were independent predictors of mortality when compared with normal LA size [LAVi ≤28ml/m2].

Conclusion: LAE was more prevalent in deceased patients and was independently associated with increased all-cause mortality in large cohort of patients with Doppler derived normal LV diastolic function and preserved LVEF.