MethodPrognostic Implications of Left Atrial Volume Index in Patients in Sinus Rhythm
Section snippets
Methods
A consecutive series of patients in normal sinus rhythm, who had undergone transthoracic echocardiography at the Liverpool Hospital Cardiology Department in 2000, was prospectively identified. The patient demographics, clinical characteristics and indications for, and results of, the studies were prospectively entered into a database (Clinical Reporting System). The following clinical characteristics were sought: diabetes mellitus, hypertension, hypercholesterolemia, current cigarette smoking,
Results
The mean age of our 470 patients was 47.3 ± 16.8 years (range 14 to 96), with 259 men (55%). The baseline clinical and echocardiographic characteristics are summarized in Table 1. The median maximum LAVI was 24 ml/m2 (interquartile range 18.6 to 30.3).
During a median follow-up of 6.8 years, 144 patients (31%) experienced at least one clinical end point event. A total of 71 patients (15%) died; 21 of these deaths were due to cardiovascular causes. In addition, 33 patients (7%) experienced a
Discussion
In our study, we have shown that, in a large unselected consecutive series of predominately younger patients referred for transthoracic echocardiography who had been followed up for a median duration of 6.8 years, an enlarged maximum LAVI of ≥24 ml/m2 was the only echocardiographic predictor of MACE, including cardiac death, heart failure, stroke, atrial fibrillation, and myocardial infarction. This predictive power was independent and incremental to the known clinical risk factors. The maximum
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2021, Indian Heart JournalReply to “Comparison of Accuracy of Left Atrial Area and Volume by Two-Dimensional Transthoracic Echocardiography Versus Computed Tomography”
2019, American Journal of CardiologyEvidence Basis for a Point-of-Care Ultrasound Examination to Refine Referral for Outpatient Echocardiography
2019, American Journal of MedicineCitation Excerpt :Presence of left atrial enlargement in echocardiography has been found to be predictive of cardiovascular events in the general elderly18 and in those with atrial fibrillation19; of congestive heart failure in the elderly with normal left ventricular systolic function20; of mortality after acute myocardial infarction21; and of all-cause mortality and ischemic stroke in a large study of 52,639 consecutive echo referrals.22 In the younger general population (mean age of 47 years), after being followed for a median of 6.8 years, patients with left atrial volume index ≥ 24 ml/m2 were more likely to experience cardiovascular mortality and morbidity.23 Even in patients with preserved left ventricular ejection fraction and normal left ventricular filling pressures, left atrial enlargement has been associated with increased risk for mortality.24
Left atrial volume index: Can it provide additional prognostic information in ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention?
2018, Revista Portuguesa de CardiologiaCitation Excerpt :Previous studies have demonstrated the prognostic significance of LA size in the general population and in patients with cardiomyopathy, CAD and valvular heart disease. In the general population, LA size measured by AP diameter, area or volume index is an independent predictor of first congestive HF episode, myocardial infarction (MI), revascularization, AF, stroke and all-cause mortality.2–6,9,10,12,27,28 In those with HF and depressed LVEF, LA size is associated with cardiovascular hospitalization and death independently of age, New York Heart Association functional class, LVEF and diastolic function.7,8,11,13,14
A Simple Score That Predicts Paroxysmal Atrial Fibrillation on Outpatient Cardiac Monitoring after Embolic Stroke of Unknown Source
2018, Journal of Stroke and Cerebrovascular DiseasesClinical and Prognostic Implications of Methods and Partition Values Used to Assess Left Atrial Volume by Two-Dimensional Echocardiography
2017, Journal of the American Society of EchocardiographyCitation Excerpt :However, the methods used in these studies for measuring maximal LA volume were not uniform: some investigators used biplane MOD,3,5,7 some applied biplane ALM,4,6,26 and others used different formulas and the no-longer-recommended single-plane algorithms.1,2 Similar variability can be found for the cutoff values of LA volume used to demonstrate the prognostic significance of LA enlargement in these studies: they varied widely from ≥24 mL/m2 to ≥45 mL/m2 to predict mortality3,5 and up to >50 mL/m2 to predict rehospitalization for heart failure.27 There have been conflicting views on the association between LA enlargement and increasing age.12,16,28