Increased Left Atrial Volume Index Predicts a Poor Prognosis in Patients With Heart Failure

Abstract

Background Left atrial volume index (LAVI) is known to reflect the duration and severity of increased left atrial pressure caused by left ventricular (LV) diastolic dysfunction. However, the prognostic value of LAVI in patients with heart failure (HF) has not been fully investigated. Methods and Results Transthoracic echocardiography was performed in 146 consecutive patients (78 men, 68 women; mean age 72 ± 12 y) who were hospitalized for HF. There were 45 cardiac events (32%) during a median follow-up period of 448 days. There were no significant differences in LV end-diastolic dimensions or ejection fraction between patients who did or did not have cardiac events. However, LAVI was markedly higher in patients with, than those without, cardiac events (56 ± 26 vs 44 ± 22 mL/m 2; P < .01). Kaplan-Meier analysis showed that there was a stepwise increase in risk of cardiac events with each increment of LAVI category, and LAVI >53.3 mL/m 2 correlated with the highest risk of cardiac events (log-rank test; P < .01). Multivariate Cox proportional hazard analysis showed that high LAVI was an independent predictor for cardiac events (hazard ratio 1.427; 95% confidence interval 1.024–1.934; P < .05). Conclusion LAVI may be useful for stratification of risk in patients with HF.