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Left atrial volume provides independent prognostic value in patients with Chagas cardiomyopathy

Maria Carmo P Nunes1, Marcia M Barbosa, Antônio Luiz P Ribeiro

  • 1ECOCENTER, Hospital Socor, Belo Horizonte, MG, Brazil. mcarmo@waymail.com.br

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
|January 10, 2009
PubMed

Insights

Left atrial volume (LAV) is a strong predictor of survival in patients with Chagas cardiomyopathy. Elevated LAV independently identifies patients at higher risk of death or transplantation, aiding clinical risk assessment.

Area of Science:

  • Cardiology
  • Echocardiography
  • Chagas Disease Research

Background:

  • Heart failure is a severe complication of Chagas disease.
  • Left atrial volume (LAV) indicates elevated left ventricular (LV) filling pressure and predicts prognosis in heart failure.
  • Assessing risk in Chagas cardiomyopathy is crucial.

Purpose of the Study:

  • To identify echocardiographic parameters of diastolic function that predict survival in Chagas cardiomyopathy.
  • To evaluate the prognostic value of LAV in Chagas cardiomyopathy.

Main Methods:

  • Prospective enrollment of 192 patients with Chagas cardiomyopathy.
  • Follow-up for death and cardiac transplantation as end points.
  • Echocardiographic assessment including LAV and diastolic function parameters.

Main Results:

  • LAV normalized for body surface area independently predicted survival (HR 1.037 per 1 mL/m², P < .001).
  • LAV provided incremental prognostic value beyond clinical factors and LV ejection fraction.
  • LAV > 51 mL/m² was significantly associated with excess mortality (log-rank, P < .001).

Conclusions:

  • LAV offers powerful, independent prognostic information for survival in Chagas cardiomyopathy.
  • A risk prediction model can be built using LAV index, NYHA class, LV ejection fraction, RV function, and E/E' ratio.
  • Clinical application of LAV for risk stratification in Chagas cardiomyopathy is recommended.
Abstract

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