Abstract 17502: Left Atrial Size and Functional Indices Measured by Three Dimensional Speckle Tracking Analysis have Higher Prognostic Values than Indices by Two dimensional Echocardiography
Background: Left atrial volume and functional indices calculated by two dimensional echocardiography (2DE) are strong predictors of future cardiac events. Prognostic values of left atrial maximum and minimum volume (LAVImax and LAVImin) and left atrial emptying fraction (LAEmpF) measured by three-dimensional speckle tracking analysis (3DSTA) were compared with the left atrial indices calculated by 2DE(2DLA indices).
Methods: LAVImax/LAVImin and LAEmpF were measured by 2DE and 3DSTA in 514 patients with various cardiovascular diseases selected randomly from our 3DSTA database. After excluding patients with atrial fibrillation and/or flutter, mitral valve disease and poor imaging, 432 (male:62 %, mean age: 65.9±15yo) were followed to record major adverse cardiovascular events (MACE: cardiac death, stroke, nonfetal MI and readmission of heart failure ). To determine the cut off values, the same indices were also calculated in 80 normal subjects.
Results: During a mean follow-up of 3.3 years, MACE developed in 89 patients, including 27 cardiac deaths. The cut-off criteria of LAVImax, LAVImin and LAempF by 2DE and 3DSTA had significant predictive power of MACE by Kaplan-Meier survival analysis (p<0.001). These six indices were still significant and independent after adjustment for clinical variables and left ventricular ejection fraction. The cut-off criteria of LAVImax, LAVImin and LAempF by 3DSTA had higher hazard ratio (HR) than the 2DLA indices (see table).
Conclusions: Left atrial size and functional indices measured by 3DSTA had higher value to predict future major cardiac events than the indices by 2DE.
Author Disclosures: M. Tsujiuchi: None.
- © 2016 by American Heart Association, Inc.