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LEFT ATRIAL VOLUME PREDICTS CONGESTIVE HEART FAILURE IN PATIENTS WITH ATRIAL FIBRILLATION
A92.E869 JACC March 9, 2010 Volume 55, issue 10A
IMAGING AND DIAGNOSTIC TESTING LEFT ATRIAL VOLUME PREDICTS CONGESTIVE HEART FAILURE IN PATIENTS WITH ATRIAL FIBRILLATION ACC Poster Contributions Georgia World Congress Center, Hall B5 Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: General Echocardiography: Prognosis and Filling Pressure by TDI and Strain Imaging Abstract Category: General Echocardiography: TTE Presentation Number: 1254-201 Authors: Satoshi Tsujimoto, Yoko Miyasaka, Kinuko Dote, Hiroshi Maeba, Fumio Yuasa, Toshiji Iwasaka, Kansai Medical University, Hirakata, Japan Background: Left atrial (LA) enlargement has been proposed as a barometer of diastolic dysfunction and a predictor of cardiovascular outcomes in patients with sinus rhythm. Whether LA volume predicts cardiovascular outcomes in patients with atrial fibrillation (AF) is not well known. Methods: To determine the clinical importance of LA volume in the prediction of congestive heart failure (CHF) in patients with AF, AF patients referred for a clinically-indicated echocardiogram, without a history of cardiac surgery, were prospectively included. CHF development was ascertained using the Framingham criteria. Cox proportional hazards modeling was used to assess the risk factors of CHF development. Results: Of 344 non-rheumatic AF patients without a history of cardiac surgery (mean 70 ± 10 year-old, 66% men), 20 (6%) developed CHF during a mean follow-up of 14.3 ± 8.3 months. In a multivariate Cox proportional hazards model, greater indexed LA volume (per 10 mL/m2; HR 1.1, 95% CI 1.0-1.3, P=0.02) was independent of age (P=0.54), sex (P=0.45), history of CHF (HR 2.9, 95% CI 1.1-8.0, P=0.03), hypertension (P=0.30), diabetes (P=0.62), and impaired LV systolic function (HR 4.7, 95% CI 1.8-12.5, P=0.002) for the prediction of CHF development. The Kaplan-Meier estimate of cumulative CHF-free survival by indexed LA volume was shown (Fig). Conclusions: In our cohort with AF, LA volume was independently predictive of CHF development, independent of LV systolic function and other cardiovascular comorbidities.
IMAGING AND DIAGNOSTIC TESTING LEFT ATRIAL VOLUME PREDICTS CONGESTIVE HEART FAILURE IN PATIENTS WITH ATRIAL FIBRILLATION ACC Poster Contributions Georgia World Congress Center, Hall B5 Tuesday, March 16, 2010, 9:30 a.m.-10:30 a.m.
Session Title: General Echocardiography: Prognosis and Filling Pressure by TDI and Strain Imaging Abstract Category: General Echocardiography: TTE Presentation Number: 1254-201 Authors: Satoshi Tsujimoto, Yoko Miyasaka, Kinuko Dote, Hiroshi Maeba, Fumio Yuasa, Toshiji Iwasaka, Kansai Medical University, Hirakata, Japan Background: Left atrial (LA) enlargement has been proposed as a barometer of diastolic dysfunction and a predictor of cardiovascular outcomes in patients with sinus rhythm. Whether LA volume predicts cardiovascular outcomes in patients with atrial fibrillation (AF) is not well known. Methods: To determine the clinical importance of LA volume in the prediction of congestive heart failure (CHF) in patients with AF, AF patients referred for a clinically-indicated echocardiogram, without a history of cardiac surgery, were prospectively included. CHF development was ascertained using the Framingham criteria. Cox proportional hazards modeling was used to assess the risk factors of CHF development. Results: Of 344 non-rheumatic AF patients without a history of cardiac surgery (mean 70 ± 10 year-old, 66% men), 20 (6%) developed CHF during a mean follow-up of 14.3 ± 8.3 months. In a multivariate Cox proportional hazards model, greater indexed LA volume (per 10 mL/m2; HR 1.1, 95% CI 1.0-1.3, P=0.02) was independent of age (P=0.54), sex (P=0.45), history of CHF (HR 2.9, 95% CI 1.1-8.0, P=0.03), hypertension (P=0.30), diabetes (P=0.62), and impaired LV systolic function (HR 4.7, 95% CI 1.8-12.5, P=0.002) for the prediction of CHF development. The Kaplan-Meier estimate of cumulative CHF-free survival by indexed LA volume was shown (Fig). Conclusions: In our cohort with AF, LA volume was independently predictive of CHF development, independent of LV systolic function and other cardiovascular comorbidities.