Prognostic Implications of Left Atrial Volume Index in Patients in Sinus Rhythm

Leung, Dominic Y., Chi, Cecilia, Allman, Christine, Boyd, Anita, Ng, Arnold C., Kadappu, Krishna K., Leung, Melissa and Thomas, Liza (2010) Prognostic Implications of Left Atrial Volume Index in Patients in Sinus Rhythm. American Journal of Cardiology, 105 11: 1635-1639. doi:10.1016/j.amjcard.2010.01.027

Author Leung, Dominic Y.
Chi, Cecilia
Allman, Christine
Boyd, Anita
Ng, Arnold C.
Kadappu, Krishna K.
Leung, Melissa
Thomas, Liza
Title Prognostic Implications of Left Atrial Volume Index in Patients in Sinus Rhythm
Journal name American Journal of Cardiology   Check publisher's open access policy
ISSN 0002-9149
Publication date 2010-06
Year available 2010
Sub-type Article (original research)
DOI 10.1016/j.amjcard.2010.01.027
Volume 105
Issue 11
Start page 1635
End page 1639
Total pages 5
Place of publication Bridgewater, NJ United States
Publisher Excerpta Medica
Collection year 2011
Language eng
Formatted abstract
The maximum left atrial volume index (LAVI) has been shown to be of prognostic values, but previous studies have largely been limited to older patients with specific cardiovascular conditions. We examined the independent prognostic values of LAVI in a large unselected series of predominantly younger patients in sinus rhythm followed up for a long period. We evaluated 483 consecutive patients (mean age 47.3 years) using transthoracic echocardiography. The median LAVI was 24 ml/m2. A primary combined end point of cardiovascular death, stroke, heart failure, myocardial infarction, and atrial fibrillation was sought. We had complete follow-up data for 97.3% of the 483 patients. During a median follow-up of 6.8 years, 86 patients (18.3%) reached the primary end point. Older age, male gender, diabetes, hypertension, hypercholesterolemia, chronic renal failure, a history of myocardial infarction or stroke, a mitral E deceleration time of ≤150 ms, and LAVI of ≥24 ml/m2 were univariate predictors of the primary end point. Event-free survival was significantly lower for patients with a LAVI of ≥24 ml/m2. Age, a history of stroke, hypertension, chronic renal failure, and male gender were independent clinical predictors. A LAVI of ≥24 ml/m2 was the only independent echocardiographic predictor (hazard ratio 1.72, 95% confidence interval 1.34 to 2.13, p = 0.018), with the chi-square of the Cox model increased significantly with the addition of the LAVI (p <0.001). The LAVI independently predicted an increased risk of cardiovascular death, heart failure, atrial fibrillation, stroke, or myocardial infarction during a median follow-up of 6.8 years. In conclusion, the prognostic values were incremental to the clinical risks and were valid in a younger, general patient population.
Keyword Ventricular Systolic Function
Acute myocardial infarction
Hypertrophic Cardiomyopathy
Heart failure
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Tue, 30 Apr 2013, 11:17:08 EST by Dr Chin Tse Arnold Ng on behalf of School of Medicine