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Preoperative left atrial volume index predicts postoperative atrial fibrillation in patients with severe aortic valve
Yoshifumi Naito1, Kazuo Yamazaki
1Department of Anesthesiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, 650-0047, Japan, naitoh44235@msn.com.
Insights
A preoperative left atrial volume index (LAVI) of 52 ml/m² or higher predicts a higher risk of postoperative atrial fibrillation in severe aortic stenosis patients undergoing valve replacement.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Left atrial enlargement is linked to diastolic dysfunction and cardiovascular risks like atrial fibrillation.
- Aortic stenosis (AS) contributes to left atrial enlargement and diastolic dysfunction progression.
Purpose of the Study:
- To assess the predictive value of preoperative left atrial volume index (LAVI) for postoperative outcomes in severe AS patients.
- To determine if LAVI can predict postoperative atrial fibrillation (POAF) after aortic valve replacement.
Main Methods:
- 47 severe AS patients undergoing aortic valve replacement were studied.
- Transthoracic echocardiography measured LAVI preoperatively.
- Patients were grouped by LAVI (<52 ml/m² vs. ≥52 ml/m²) to assess POAF incidence and other outcomes.
Main Results:
- The incidence of POAF was significantly lower in patients with LAVI <52 ml/m² (25.9%) compared to those with LAVI ≥52 ml/m² (65.0%).
- Other postoperative parameters showed a trend towards being higher in the higher LAVI group, but differences were not statistically significant.
Conclusions:
- Preoperative LAVI ≥52 ml/m² may serve as a useful predictor for POAF in severe AS patients.
- Further research is needed to confirm LAVI's efficacy in predicting other postoperative outcomes.
Purpose:
Left atrial enlargement correlates with the severity of diastolic dysfunction and is a predictor of cardiovascular complications such as atrial fibrillation. Aortic valve stenosis (AS) causes left atrial enlargement and progression of diastolic dysfunction. The aim of this study was to investigate the efficacy of the preoperative left atrial volume index (LAVI) in predicting postoperative outcome in patients with severe AS.
Methods:
Forty-seven patients with severe AS who underwent aortic valve replacement were examined. Transthoracic echocardiography and LAVI measurement were performed on admission. Patients were divided into two groups according to optimal cut-off values of LAVI derived from receiver operating characteristic curves for postoperative atrial fibrillation (POAF) (group S: LAVI <52 ml/m(2), group L: LAVI ≥52 ml/m(2)). The incidence of POAF, ventilation time, inotropic support time, duration of stay in intensive care, and overall duration of hospital stay were evaluated.
Results:
By univariate analysis, the incidence of POAF in group S was significantly lower than that in group L (25.9 and 65.0%, respectively; P < 0.01). Values for other parameters were higher in group L, although the differences were insignificant.
Conclusion:
In patients with severe AS, a preoperative LAVI of ≥52 ml/m(2) may be a useful predictor of POAF, although the efficacy of this index for predicting other postoperative outcomes has yet to be determined.
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