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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Left Atrial Volume Assessed by Coronary Computed Tomography in Mid Ventricular Diastasis Predicts Adverse Events

Kevin E Boczar1, Mohammed Alam, Benjamin J W Chow

  • 1*Department of Medicine (Cardiology), University of Ottawa Heart Institute †Department of Radiology, University of Ottawa, ON, Canada.

Journal of Thoracic Imaging
|July 22, 2016
PubMed

Insights

Left atrial volume indexed to body surface area (LAVi) measured during mid-diastole is a significant predictor of major adverse cardiac events (MACE). This measurement offers incremental prognostic value beyond traditional risk factors.

Area of Science:

  • Cardiology
  • Cardiac Imaging
  • Predictive Analytics

Background:

  • Left atrial (LA) volume is a known prognostic marker for major adverse cardiac events (MACE).
  • The predictive capacity of LA volume specifically during mid-diastole remains underexplored.
  • This study investigates the prognostic utility of LA volume indexed to body surface area (LAVi) at mid-ventricular diastasis.

Purpose of the Study:

  • To determine the incremental predictive value of LAVi measured in mid-ventricular diastasis for MACE.
  • To assess if LAVi provides prognostic information beyond established risk factors.

Main Methods:

  • A case-control study matched 96 patients with MACE to 96 controls.
  • Coronary computed tomographic angiography images were analyzed at the 75% phase (mid-ventricular diastasis).
  • Left atrial volumes were measured, indexed to body surface area (LAVi), and analyzed using Cox proportional hazard models.

Main Results:

  • Patients with MACE exhibited significantly larger LAVi (63.8±2.1 mL/m) compared to controls (50.3±1.2 mL/m) (P<0.001).
  • Multivariate analysis identified both significant coronary artery disease (>70% stenosis) and LAVi as independent predictors of MACE (P=0.0022 and P=0.0001, respectively).

Conclusions:

  • A larger LAVi is significantly associated with MACE.
  • LAVi serves as an incremental predictor of MACE, adding value to traditional clinical variables.
  • Incorporating LAVi assessment into coronary computed tomographic angiography could enhance cardiovascular risk stratification and clinical decision-making.
Abstract

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