Factors Associated with Left Atrial Enlargement in Patients with Anemia Caused by Uterine Myoma

Soo Ho Kim,Min-Kyung Kang

doi:10.4172/2155-9880.1000456

Abstract

Background: Uterine myoma (UM) is common among female gender, and it often causes anemia. Left atrial enlargement (LAE) is commonly detected in patients with anemia as well as caused by uterine myoma. Therefore, this study was aimed to investigate the clinical implications of LAE and its associating factors in patients with anemia caused by UM. Methods: This is a retrospective observational cross sectional study and it considered 139 female patients with UM who had undergone preoperative echocardiography. Patients were sorted into 2 groups according to the presence of LAE (n=60) or not (n=79). LAE was defined as LA volume index (LAVI) was 35 ml/m2 or more. Results: Patients with LAE (LAVI: 41.0 ± 5.3 ml/m2) showed larger left ventricular (LV) dimension and increased LV mass index (LVMI) than patients without LAE (LAVI: 27.9 ± 3.9 ml/m2). Patients with LAE were older, showed slower heart rate (HR) and further decreased level of hemoglobin. Older age, slower HR, level of hemoglobin, larger LV, increased LMI, E/E’, right ventricular systolic pressure and decreased S’ velocity were shown to be correlated with increased LAVI. Among them, older age (OR: 1.119, 95% CI: 1.014-1.236, p=0.026) and slower HR (OR: 0.926, 95% CI: 0.878-0.977, p=0.005) were independently associated with LAE in patients with anemia caused by UM. Conclusion: LAE was often noticed in patients with anemia caused by UM and older age and slower HR were seemed to be its associating factor.

Highlights

Left atrial (LA) enlargement is associated with poor prognosis and cardiovascular events such as cerebral infarction and heart failure (HF) and as well as adverse overall outcomes [1,2,3]
LA volume overload resulting from mitral valve regurgitation, arteriovenous fistula, left to right shunt, or high cardiac output state can contribute to LA enlargement (LAE) [5]
There was no significant difference of ejection fraction (EF) between the two groups, but S’ which related to left ventricular (LV) systolic function, was slightly lower in patients with Left atrial enlargement (LAE) (S’: 7.8 ± 1.3 vs. 8.3 ± 1.4 cm/s, p=0.039)

Summary

Introduction

Left atrial (LA) enlargement is associated with poor prognosis and cardiovascular events such as cerebral infarction and heart failure (HF) and as well as adverse overall outcomes [1,2,3]. LA volume overload resulting from mitral valve regurgitation, arteriovenous fistula, left to right shunt, or high cardiac output state can contribute to LA enlargement (LAE) [5]. There are only few studies exist which evaluating cardiac enlargement [9] or clinical implications [10,11] in patients with chronic anemia. We aimed to study on factors associated with LAE and its clinical implications in patients with anemia caused by UM in South Korea. Left atrial enlargement (LAE) is commonly detected in patients with anemia as well as caused by uterine myoma.

Objectives

Methods

Results

Conclusion