scholarly journals LEFT ATRIAL VOLUME INDEX PREDICTS MORTALITY IN PATIENTS WITH NORMAL LEFT VENTRICULAR FILLING PRESSURE AND PRESERVED EJECTION FRACTION

2012 ◽  
Vol 59 (13) ◽  
pp. E1125
Author(s):  
Dharmendrakumar A. Patel ◽  
Carl Lavie ◽  
Yvonne Gilliland ◽  
Sangeeta Shah ◽  
Homeyar Dinshaw ◽  
...  
Keyword(s):  
Left Atrial Volume ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Volume Index ◽  
Preserved Ejection Fraction ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Normal Left Ventricular ◽  
Ventricular Filling Pressure ◽  
Ventricular Filling

Abstract 4205: Left Atrial Volume Index and Left Ventricular Geometry Independently Predict Mortality in 47,865 Patients with Preserved Ejection Fraction

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Dharmendrakumar A Patel ◽  
Carl J Lavie ◽  
Richard V Milani ◽  
Hector O Ventura
Keyword(s):  
Ejection Fraction ◽  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Mortality Prediction ◽  
Volume Index ◽  
Left Ventricular Geometry ◽  
Preserved Ejection Fraction ◽  
Atrial Volume ◽  
Left Atrial Volume Index

Background: LV geometry predicts CV events but it is unknown whether left atrial volume index (LAVi) predicts mortality independent of LV geometry in patients with preserved LVEF. Methods: We evaluated 47,865 patients with preserved EF to determine the impact of LAVi and LV geometry on mortality during an average follow-up of 1.7±1.0 years. Results: Deceased patients (n=3,653) had significantly higher LAVi (35.3 ± 15.9 vs. 29.1 ± 11.9, p<0.0001) and abnormal LV geometry (60% vs. 41%, p<0.0001) than survivors (n=44,212). LAVi was an independent predictor of mortality in all four LV geometry groups [Hazard ratio: N= 1.007 (1.002–1.011), p=0.002; concentric remodeling= 1.008 (1.001–1.012), p<0.0001; eccentric hypertrophy= 1.012 (1.006 –1.018), p<0.0001; concentric hypertrophy=1.017 (1.012–1.022), p<0.0001; Figure ]. Comparison of models with and without LAVi for mortality prediction was significant suggesting increased mortality prediction by addition of LAVi to other independent predictors (Table ). Conclusion: LAVi is higher and LV geometric abnormalities are more prevalent in deceased patients with preserved systolic function and are independently associated with increased mortality. LAVi predicts mortality independent of LV geometry and has synergistic influence on all cause mortality prediction in large cohort of patients with preserved ejection fraction.

Abstract 4201: A New Echo Index, Left Atrial Volume Index Over Late Diastolic Mitral Annulus Velocity Can Predict Elevated Left Ventricular Filling Pressures And Clinical Outcomes

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Hun-Jun Park ◽  
Mahn-Won Park ◽  
Byung-Joo Shim ◽  
Mi-Jung Lee ◽  
Jae-Hong Park ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Clinical Outcomes ◽  
Left Atrial Volume ◽  
Mitral Annulus ◽  
Left Ventricular ◽  
Volume Index ◽  
Atrial Volume ◽  
Left Atrial Volume Index ◽  
Mitral Annulus Velocity ◽  
Ventricular Filling

Background: Another non-invasive method for prediction of elevated left ventricular filling pressure (LVFP) have attracted attention in clinical practice. Objectives: This study was to verify the clinical usefulness of left atrial volume index over late diastolic mitral annulus velocity (LAVi/A′) for the predictors of advanced (pseudonormal to restrictive physiology) diastolic dysfunction in the presence of elevated LVFP and clinical outcomes using right heart catheterization (RHC). Methods: 163 patients (95 men, mean age 61±13 years) with dyspnea underwent comprehensive Doppler echocardiography, RHC and B-type natriuretic peptide (BNP) measurement. Using ROC curve, we compared the areas under the curves (AUC) of LAVi/A′, transmitral early diastolic/annular velocity ratio (E/E′), and BNP level for the prediction of advanced diastolic dysfunction. During a median follow-up of 13.3 months, the incidence of the composite outcomes of cardiac death or re-hospitalization for heart failure was compared based on the optimal cut-off value of LAVi/A′. Results: The AUC of LAVi/A′ was comparable to that of BNP (0.91 vs. 0.90; p=0.78) and E/E′ (0.91 vs. 0.93; p=0.78) for prediction of advanced diastolic dysfunction. 68/163 (41.7%) patients had LAVi/A′ ≥4.0 and they had significantly higher BNP level and longer time difference between atrial reversal flow of pulmonary vein and transmitral late diastolic flow (AR dur -A dur ) compared with those of LAVi/A′ <4.0 (BNP: 1207±1212 vs. 176±365 pg/ml; AR dur -A dur: 24.6±21.1 vs. −3.3±15.9 msec, p<0.001, respectively). The LAVi/A′ had a reasonable correlation with mean PCWP (r=0.64, r 2 =0.41, p=0.001), which was comparable to that of E/E′ (r=0.60, r 2 =0.36, p=0.002). On Cox proportional hazard analysis, EF<50%, age ≥65 years, and LAVi/A′ ≥4.0 were independent outcome predictors with odds ratios of 4.8 (95% CI: 2.0 to 11.7), 3.8 (95% CI: 1.8 to 7.8), and 3.9 (95% CI: 1.5 to 9.8), respectively (p<0.01 for all). Conclusions: LAVi/A′ ≥4.0 is useful clinical predictors for advanced diastolic dysfunction in the presence of elevated LVFP and clinical outcomes.

scholarly journals Left atrial volume predicts abnormal exercise left ventricular filling pressure

2014 ◽  
Vol 16 (10) ◽  
pp. 1089-1095 ◽  
Author(s):  
Nadjib Hammoudi ◽  
Marc Achkar ◽  
Florent Laveau ◽  
Lila Boubrit ◽  
Morad Djebbar ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Volume ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Left Ventricular Filling ◽  
Left Ventricular Filling Pressure ◽  
Atrial Volume ◽  
Ventricular Filling Pressure ◽  
Ventricular Filling

Abstract 13798: Influence of Advanced Pulmonary Vascular Remodeling on Accuracy of Echocardiographic Parameters of Left Ventricular Filling Pressure

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Yasuyuki Chiba ◽  
Hiroyuki Iwano ◽  
Sanae Kaga ◽  
mio shinkawa ◽  
Michito Murayama ◽  
...  
Keyword(s):  
Left Atrial Volume ◽  
Right Heart Catheterization ◽  
Left Ventricular ◽  
Filling Pressure ◽  
Vascular Lesions ◽  
Volume Index ◽  
Control Group ◽  
Heart Catheterization ◽  
Left Atrial Volume Index ◽  
Echocardiographic Parameters

Introduction: Evaluation of left ventricular (LV) filling pressure (FP) plays an important role in the clinical management of pulmonary hypertension (PH). However, the accuracy of echocardiographic parameters for the estimation of LV FP in the presence of pulmonary vascular lesions has not been fully addressed. Methods: We investigated 87 patients diagnosed with PH due to pulmonary vascular lesions (non-cardiac PH; PH NC ) (PH NC group) and 117 patients with ischemic heart disease without reduced LV ejection fraction (<40%) (control group). Mean pulmonary arterial wedge pressure (PAWP) and pulmonary vascular resistance (PVR) were obtained by right heart catheterization. As echocardiographic parameters of LV FP, the ratio of early- (E) to late-diastolic transmitral flow velocity (E/A), ratio of E to early-diastolic mitral annular velocity (E/e'), and left atrial volume index (LAVI) were measured. The PH NC group was subdivided into non-severe and severe groups according to median PVR (5.3 Wood units). Results: PAWP was 12±5 mmHg in controls, 9±4 mmHg in non-severe PH NC , and 8±3 mmHg in severe PH NC . In the control and non-severe PH NC groups, positive correlations were observed between PAWP and E/A (R=0.66 and R=0.41, respectively), E/e' (R=0.36 and R=0.33), and LAVI (R=0.38 and R=0.62). In contrast, in the severe PH NC group, PAWP was only correlated with LAVI (R=0.41, p=0.006). In the control group, PAWP determined E (β=0.45, p<0.001) but PVR did not, whereas both PAWP and PVR were independent determinants of E (β=0.32, p=0.001; and β=-0.35, p<0.001, respectively) in the PH NC group. Conclusions: In the presence of advanced pulmonary vascular lesions, conventional Doppler echocardiographic parameters may not accurately reflect LV FP. Importantly, elevated PVR would lower the E value, even when PAWP is elevated, resulting in blunting of these parameters for the detection of elevated LV FP. LAVI might be a reliable parameter for estimating LV FP in patients with severe non-cardiac PH.

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