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Prognostic Role of Left Atrial Volume in Elderly Patients with Symptomatic Stable Chronic Heart Failure: Comparison with Left Ventricular Diastolic Dysfunction and B‐Type Natriuretic Peptide
Author(s) -
Popescu Bogdan A.,
Popescu Andreea C.,
AntoniniCanterin Francesco,
Rubin Daniela,
Cappelletti Piero,
Piazza Rita,
Ginghina Carmen,
Dimulescu Doina,
Beladan Carmen C.,
Luigi Nicolosi Gian
Publication year - 2007
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/j.1540-8175.2007.00540.x
Subject(s) - cardiology , medicine , heart failure , ejection fraction , sinus rhythm , hazard ratio , natriuretic peptide , diastole , cohort , brain natriuretic peptide , atrial fibrillation , confidence interval , blood pressure
Background: Left atrial (LA) volume and B‐type natriuretic peptide (BNP) represent powerful outcome predictors in patients with heart failure (HF).Aim: To assess the comparative prognostic role of LA volume (indexed to body surface area, LAVi), left ventricular diastolic dysfunction (LVDD) and BNP levels on long‐term outcome in patients with symptomatic but stable chronic HF. Methods: We studied consecutively 46 patients with symptomatic stable chronic HF (73 ± 10 years, 30 men), in sinus rhythm, without significant valvular disease. Echocardiographic measurements included: LV mass, LV volumes and ejection fraction, and LAVi. LVDD was graded using a comprehensive Doppler algorithm. Blood taken before echocardiography was assayed for BNP levels. Primary end point was combined: all‐cause mortality and hospitalization for worsening HF. Results: During 20 ± 14 months of follow‐up 19 events occurred: 8 deaths, and 11 hospitalizations for HF. In univariate analyses LAVi, LVDD, BNP levels, LV ejection fraction, LV volumes, and LV mass were significant outcome predictors (P < 0.05). At multivariate regression LAVi was the only independent predictor of outcome (hazard ratio: 1.03 per 1 ml/m 2 increase, 95% CI: 1.01–1.06, P = 0.02). Conclusion: Although directly related to LVDD and to BNP levels, only LAVi emerged as an independent outcome predictor in this cohort of elderly patients with symptomatic stable chronic HF.