Abstract 11565: Clinical Implications of Left Atrial Size and Its Changes After Cardiac Resynchronization Therapy in Patients With Heart Failure

Abstract

Background: Little evidence is available regarding the impact of left atrial (LA) diameter, especially its changes after cardiac resynchronization therapy (CRT), on the prognosis of patients with heart failure (HF). Objective: To investigate the association of LA diameter and its changes with all-cause mortality and HF hospitalization in HF patients with CRT. Methods: This cohort study retrospectively included 488 HF patients with CRT, who were assessed with echocardiography at baseline and 6 months after CRT. The multivariate Cox proportional hazards regression models were used to examine the specific association of LA diameter and its changes with all-cause mortality and HF hospitalization. Results: Non-linear associations were found for LA diameter with all-cause mortality ( P = 0.006 for nonlinearity) and HF hospitalization ( P = 0.02 for nonlinearity). The positive association of LA diameter with all-cause mortality (HR, 1.88; 95% CI, 1.42-2.49) and HF hospitalization (HR, 1.72; 95% CI, 1.32-2.22) only in the range of LA diameter <45 mm. There was a positive association of LA diameter changes with all-cause mortality (HR, 1.29; 95% CI, 1.12-1.48) and HF hospitalization (HR, 1.28; 95% CI, 1.13-1.45). LA adverse remodeling (LAAR) was associated with an increased risk of all-cause mortality (HR, 2.35; 95% CI, 1.46-3.79) and HF hospitalization (HR, 2.18; 95% CI, 1.40-3.41). Conclusions: LA enlargement and LAAR were associated with an unfavorable outcome in HF patients with CRT. These findings suggest that monitoring LA diameter and its changes has potential clinical implications for HF treatment.