Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction

Patel, Dharmendrakumar A., Lavie, Carl J., Gilliland, Yvonne E., Shah, Sangeeta B., Dinshaw, Homeyar K. and Milani, Richard V. (2015) Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction. Mayo Clinic Proceedings, 90 11: 1499-1505. doi:10.1016/j.mayocp.2015.07.021

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Author Patel, Dharmendrakumar A.
Lavie, Carl J.
Gilliland, Yvonne E.
Shah, Sangeeta B.
Dinshaw, Homeyar K.
Milani, Richard V.
Title Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction
Journal name Mayo Clinic Proceedings   Check publisher's open access policy
ISSN 0025-6196
1942-5546
Publication date 2015-11-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.mayocp.2015.07.021
Open Access Status Not yet assessed
Volume 90
Issue 11
Start page 1499
End page 1505
Total pages 7
Place of publication New York, United States
Publisher Elsevier
Language eng
Formatted abstract
Objective

To describe the prevalence of left atrial (LA) enlargement (LAE) and its association with all-cause mortality in 10,719 patients with an early diastolic transmitral flow velocity (E) to early diastolic mitral annular velocity (e′) ratio–determined normal left ventricular (LV) filling pressure and preserved LV ejection fraction (LVEF).

Methods

We evaluated 10,719 patients (deceased patients: n=479; mean [SD] age, 65 [14] years; 60% male; surviving patients: n=10,240; mean (SD) age, 54 (16) years; 48% male) with estimated normal LV filling pressure (E/e′ ratio ≤8) and preserved LVEF (≥50%) to determine the impact of LA volume index (LAVi) on all-cause mortality during a mean (SD) follow-up of 2.2 (1.0) years.

Results

In the univariate analysis, with every milliliter per square meter increase in LAVi, all-cause mortality risk increased by 3% (hazard ratio [HR], 1.03; 95% CI, 1.02-1.04; P<.001). After adjusting for covariates, LAVi (as a continuous variable) was an independent predictor of all-cause mortality (HR, 1.015; 95% CI, 1.005-1.026; P=.01). When LAVi was assessed as a categorical variable with normal LAVi (≤28 mL/m2) as the reference group, moderate LAVi (34-39 mL/m2) and severe LAVi (≥40 mL/m2) were independent predictors of all-cause mortality (HR, 1.34; 95% CI, 1.01-1.79; P=.04; and HR, 1.65; 95% CI, 1.18-2.29; P=.003, respectively).

Conclusion

LAE was independently associated with an increased risk of all-cause mortality in our large cohort of 10,719 patients with normal LV filling pressure and preserved LVEF.
Keyword Diastolic Dysfunction
Prognostic Value
Geometry
Size
Risk
Echocardiography
Hypertrophy
Doppler
Disease
Stroke
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
 
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