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Evaluation of Left Ventricular Structure and Function using 3D Echocardiography
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Prognostic value of left atrial volume in patients with dilated cardiomyopathy

Filipa Ferreira1, Ana Galrinho, Rui Soares

  • 1Serviço de Cardiologia, Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Lisboa, Portugal.

Revista Portuguesa De Cardiologia : Orgao Oficial Da Sociedade Portuguesa De Cardiologia = Portuguese Journal of Cardiology : an Official Journal of the Portuguese Society of Cardiology
|October 15, 2013
PubMed

Insights

Left atrial volume (LAV) predicts adverse outcomes in dilated cardiomyopathy (DCM) patients. LAV is the sole echocardiographic predictor of mechanical ventricular assistance, heart transplantation, or death in DCM.

Area of Science:

  • Cardiology
  • Echocardiography
  • Heart Failure Research

Background:

  • Left atrial (LA) size is a known mortality predictor in the general population.
  • LA size variability in dilated cardiomyopathy (DCM) patients warrants further investigation.
  • The prognostic significance of LA volume (LAV) in DCM is not well-established.

Purpose of the Study:

  • To determine the long-term prognostic value of LAV in patients diagnosed with DCM.
  • To identify echocardiographic markers for risk stratification in DCM patients.

Main Methods:

  • Prospective study of DCM patients in sinus rhythm (January-December 2004).
  • Comprehensive resting and stress echocardiography performed.
  • Cox regression analysis for univariate and multivariate assessment of composite endpoints (mechanical ventricular assistance, transplantation, or death).

Main Results:

  • 35 DCM patients (mean age 52.0, 68.6% male) were studied; 82.9% had non-ischemic etiology.
  • Ejection fraction (EF) was 31.1 ± 9.4%.
  • LAV emerged as the sole significant multivariate predictor of adverse outcomes (HR 7.7, p=0.05) with a cut-off of 63 ml, unlike EF or LV dimensions.

Conclusions:

  • Left atrial volume (LAV) is a critical echocardiographic determinant for predicting mechanical ventricular assistance, heart transplantation, or death in DCM patients.
  • Conventional risk stratification parameters like EF and LV dimensions lacked prognostic significance in this DCM cohort.
  • LAV measurement provides valuable prognostic information for DCM management.
Abstract

Keywords:
Cardiomiopatia dilatadaDilated cardiomyopathyEchocardiographic prognostic valueLeft atrial volumeValor prognóstico ecocardiográficoVolume aurícula esquerda

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