Validation of Alternative Left Atrial Indexation Methods in Obesity

Abstract

Echocardiography guidelines recommend indexing left atrial (LA) size to body surface area (BSA) to account for body size.1 Indexation may, however, not be appropriate in patients with abnormal body stature as in obesity.2 Davis et al.2 recently showed that BSA indexation inadvertently affects the association between LA size and mortality in severely obese patients. Limitations to this study included the retrospective design and use of the ellipsoid method for quantifying LA size. We sought to validate their findings in a general population-based study with LA size quantified by the area-length method.