Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction
Background. Indexed left atrial volume (LAVi) is a robust predictor of adverse cardiovascular events. A minority of patients with moderate-to-severe left ventricular (LV) systolic dysfunction maintain normal LAVi. We followed clinical and echocardiographic parameters for at least 6 months to underst...
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Wiley
2018-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2018/7512758 |
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| author | Dipika Gopal Jing Wang Yuchi Han |
| author_facet | Dipika Gopal Jing Wang Yuchi Han |
| author_sort | Dipika Gopal |
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| description | Background. Indexed left atrial volume (LAVi) is a robust predictor of adverse cardiovascular events. A minority of patients with moderate-to-severe left ventricular (LV) systolic dysfunction maintain normal LAVi. We followed clinical and echocardiographic parameters for at least 6 months to understand how this population is different from patients with similar systolic dysfunction and dilated left atria. Methods and Results. We searched our electronic medical records for “normal” n=817 and “severely dilated” n=1094 LA size and LV ejection fraction (EF) ≤ 35% on echocardiogram reports from 2009 to 2015. We analyzed 115 subjects for LAVi, biplane EF, and diastolic parameters over 2 echocardiograms at least 6 months apart. Younger age, white race, being on an angiotensin-converting enzyme inhibitor, smaller end-diastolic LV volume (LVEDV), and longer deceleration time (DT) were associated with having a normal LAVi. The receiver-operating characteristic curve has an area under the curve of 0.95 p<0.0001 for this model. An increase in LVESVi and early mitral flow velocity and a decrease in DT explain 32% of the variance seen in LAVi increase over time. Conclusion. In patients with moderate-to-severely reduced EF, younger age, being on heart failure therapies, and better diastolic dysfunction were independently associated with a normal LAVi. Improvement in systolic and diastolic performances was associated with decreasing LAVi with 6-month to 1-year follow-up. |
| format | Article |
| id | doaj-art-75c0484ff2834bc789bcd023df44251a |
| institution | OA Journals |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
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| series | Cardiology Research and Practice |
| spelling | doaj-art-75c0484ff2834bc789bcd023df44251a2025-08-20T02:06:58ZengWileyCardiology Research and Practice2090-80162090-05972018-01-01201810.1155/2018/75127587512758Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection FractionDipika Gopal0Jing Wang1Yuchi Han2Cardiovascular Division, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USACardiovascular Division, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USACardiovascular Division, Department of Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA 19104, USABackground. Indexed left atrial volume (LAVi) is a robust predictor of adverse cardiovascular events. A minority of patients with moderate-to-severe left ventricular (LV) systolic dysfunction maintain normal LAVi. We followed clinical and echocardiographic parameters for at least 6 months to understand how this population is different from patients with similar systolic dysfunction and dilated left atria. Methods and Results. We searched our electronic medical records for “normal” n=817 and “severely dilated” n=1094 LA size and LV ejection fraction (EF) ≤ 35% on echocardiogram reports from 2009 to 2015. We analyzed 115 subjects for LAVi, biplane EF, and diastolic parameters over 2 echocardiograms at least 6 months apart. Younger age, white race, being on an angiotensin-converting enzyme inhibitor, smaller end-diastolic LV volume (LVEDV), and longer deceleration time (DT) were associated with having a normal LAVi. The receiver-operating characteristic curve has an area under the curve of 0.95 p<0.0001 for this model. An increase in LVESVi and early mitral flow velocity and a decrease in DT explain 32% of the variance seen in LAVi increase over time. Conclusion. In patients with moderate-to-severely reduced EF, younger age, being on heart failure therapies, and better diastolic dysfunction were independently associated with a normal LAVi. Improvement in systolic and diastolic performances was associated with decreasing LAVi with 6-month to 1-year follow-up.http://dx.doi.org/10.1155/2018/7512758 |
| spellingShingle | Dipika Gopal Jing Wang Yuchi Han Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction Cardiology Research and Practice |
| title | Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction |
| title_full | Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction |
| title_fullStr | Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction |
| title_full_unstemmed | Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction |
| title_short | Determinants of Normal Left Atrial Volume in Heart Failure with Moderate-to-Severely Reduced Ejection Fraction |
| title_sort | determinants of normal left atrial volume in heart failure with moderate to severely reduced ejection fraction |
| url | http://dx.doi.org/10.1155/2018/7512758 |
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