Author + information
- Giovanni Benfari,
- Clemence Antoine,
- Andrea Rossi,
- Wayne Miller,
- Hector Michelena,
- Vuyisile Nkomo and
- Maurice Sarano
Background: Left atrial enlargement is frequent in patients with left ventricular dysfunction (LVD) but is construed as secondary to LVD and its prognostic value is unknown. To assess whether left atrial volume index (LAVI) is an independent prognostic marker in LVD, a large series allowing comprehensive adjustment is required
Methods: All patients with LVD (EF <50%) and a LAVI measurement performed in routine practice at Mayo Clinic, Rochester between 2003 and 2011 were enrolled. Echo-Doppler features of LVD, hemodynamics, as well as, symptoms and comorbidities were obtained.
Results: LAVI was evaluated in 14211 consecutive patients with LVD (age 68±14 years, 31% female, EF=36±10%). LAVI was 44±17 ml/m2 overall and severely enlarged (>48 ml/m2) in 32% of this cohort. During follow-up of 4.5±3.5 years, 7214 patients died with LAVI being univariately predictive of mortality, hazard-ratio (HR) 1.13 [1.12-1.14] per 10mL/m2; p<0.0001. After adjustment for age, sex, EF, comorbidities, mitral valve regurgitation, dyspnea, pulmonary pressure and diastolic function, LAVI remained highly predictive of outcome HR 1.05 [1.03-1.06] per 10mL/m2; p<0.0001. The figure illustrates survival according to LAVI severity stratification.
Conclusions: LAVI measured in routine practice is a quantitative prognostic marker in LVD, predicting survival independently from other comprehensive prognostic factors as well as comorbidity. LAVI measurement should be included in risk stratification of LVD.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Making Progress in Understanding Heart Failure
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1123-264
- 2017 American College of Cardiology Foundation