Abstract
BackgroundPrevious studies showed that left atrial enlargement is an independent marker of adverse outcomes in both primary and secondary cardiovascular prevention. However, no data are available on long-term outcomes in patients undergoing valve surgery and/or coronary artery by-pass graft (CABG) surgery. Aim of the study was to evaluate long-term prognostic role of left atrial volume index (LAVi) after cardiac surgery, using the cutoff values recently proposed by the European Association of Cardiovascular Imaging and American Society of Echocardiography.MethodsWe created a retrospective registry of 1703 consecutive patients who underwent cardiovascular rehabilitation program after cardiac surgery, including CABG, valve surgery and valve + CABG surgery. LAVi was calculated as ratio of left atrium volume to body surface area, in ml/m2 at discharge; 563 patients with available LAVi data were included in the study.ResultsIn the whole population LAVi was 36 ± 14 ml/m2 (mean ± SD) and the follow-up time was 5 ± 1.5 years. Increased LAVi (>34 ml/m2) predicted major adverse cardiovascular and cerebrovascular events (MACCEs) (HR = 2.1; CI95 %: 1.4–3.1; p < 0.001) and cardiovascular mortality (HR = 2.2; CI95 %: 1.0–4.5; p = 0.032). An increased LAVi remained MACCEs predictor after adjustement for age, gender, diabetes, atrial fibrillation at discharge, echocardiographic E/A ratio and left ventricular ejection fraction (HR = 1.8; CI95 %: 1.0–3.0; p = 0.036). When the study population was split according to increasing LAVi values, left atrium enlargement resulted a predictor of progressively worse adverse outcome.ConclusionsLAVi is a predictor of long-term adverse cardiovascular outcome after cardiac surgery, even after correction for main clinical and echocardiographic variables. The recently recommended LAVi severity cutoffs appear adequate to effectively stratify outcome in patients undergoing rehabilitation after cardiac surgery.
Highlights
Previous studies showed that left atrial enlargement is an independent marker of adverse outcomes in both primary and secondary cardiovascular prevention
left atrial volume index (LAVi) is a predictor of long-term adverse cardiovascular outcome after cardiac surgery, even after correction for main clinical and echocardiographic variables
There is a growing body of evidence demonstrating that Left atrium (LA) enlargement is an independent marker of adverse outcomes both in primary [3,4,5,6,7] and secondary [8,9,10,11] cardiovascular prevention, to date, there are no published data assessing long-term outcome in patients undergoing valve and coronary artery by-pass graft (CABG) surgery
Summary
Previous studies showed that left atrial enlargement is an independent marker of adverse outcomes in both primary and secondary cardiovascular prevention. No data are available on long-term outcomes in patients undergoing valve surgery and/or coronary artery by-pass graft (CABG) surgery. There is a growing body of evidence demonstrating that LA enlargement is an independent marker of adverse outcomes both in primary [3,4,5,6,7] and secondary [8,9,10,11] cardiovascular prevention, to date, there are no published data assessing long-term outcome in patients undergoing valve and coronary artery by-pass graft (CABG) surgery
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
