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The Association Between Baseline Left Atrial Volume Index and All-Cause Mortality in Patients with Heart Failure: A
Insights
Left atrial volume index (LAVI) is a significant predictor of mortality in heart failure (HF) patients. Each 10 mL/m2 increase in baseline LAVI correlates with a 22% higher risk of all-cause mortality.
Area of Science:
- Cardiology
- Echocardiography
- Prognostic Biomarkers
Background:
- Left atrial enlargement is a known mortality risk factor in the general population.
- Left atrial volume index (LAVI) is a proposed prognostic measure for heart failure (HF).
Purpose of the Study:
- To evaluate baseline LAVI as an independent predictor of all-cause mortality in HF patients.
- To synthesize evidence from existing studies on the prognostic value of LAVI in heart failure.
Main Methods:
- Systematic meta-analysis of four studies identified via Medline and Embase.
- Inclusion criteria: HF cohorts, multivariate analysis of LAVI and mortality, reported data on LAVI (mL/m2) and all-cause mortality.
- Pooled adjusted hazard ratios using random-effects meta-analysis.
Main Results:
- A 10 mL/m2 increase in baseline LAVI was associated with a 22% increased adjusted hazard of all-cause mortality.
- Confidence interval for this association was 13% to 31% (I2 = 14%).
Conclusions:
- Baseline LAVI is a crucial independent predictor of all-cause mortality in heart failure.
- Routine reporting of LAVI in echocardiography for HF patients is recommended.
Background:
Enlargement of the left atrium is a marker of mortality in the general population. Left atrial volume index (LAVI) has long been proposed as a measure of prognosis in patients with heart failure (HF). The aim of this meta-analysis was to assess the utility of using baseline LAVI as an independent predictor of all-cause mortality in patients with HF.
Methods:
A search of Medline and Embase bibliographic databases was performed to identify studies meeting the following inclusion criteria: 1) studies evaluating a cohort of patients with HF (both reduced and preserved ejection fraction); 2) studies conducting multivariate analysis or patient matching to determine the relationship between baseline LAVI measured by echocardiography and all-cause mortality; and 3) studies reporting data on the relationship between baseline LAVI (per difference in mL/m2) and all-cause mortality. Adjusted hazard ratios depicting the association between baseline LAVI and all-cause mortality were pooled using traditional random-effects meta-analysis.
Results:
1,188 publications were reviewed from which four studies were included in the present meta-analysis. We found each 10 mL/m2 increase in baseline LAVI was associated with a 22% increased adjusted hazard of all-cause mortality (95% confidence interval, 13% to 31%, I2 = 14%).
Conclusion:
Baseline LAVI is an important independent predictor of all-cause mortality in patients with heart failure and should be reported routinely in these patients undergoing echocardiography.
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