Assessing Left Atrial Volume Indexation to Predict Mortality in Individuals With Overweight and Obesity

Area of Science:

• Cardiology
• Echocardiography
• Prognostic Biomarkers

Background:

• Left atrial volume (LAV) indexation methods are explored to improve proportional scaling over standard body surface area (BSA) indexation.
• Limited data exist on the long-term prognostic value of alternative LAV indices in overweight or obese individuals.

Purpose of the Study:

• To compare the performance of various LAV indexation methods in predicting all-cause mortality.
• To evaluate prognostic value in individuals with overweight or obesity.

Main Methods:

• Utilized data from the National Echocardiography Database Australia linked to mortality outcomes.
• Included individuals with body mass index ≥25 kg/m².
• Compared 9 LAV indices using receiver operating characteristic analyses and survival analysis.

Main Results:

• Most LAV indexation methods showed similar performance in predicting all-cause mortality (AUC 0.60-0.62).
• LAV and LAV/BMI had the lowest AUCs.
• A mortality threshold for LAV/BSA was observed at 34 mL/m², consistent across sexes.

Conclusions:

• The majority of LAV indices performed similarly in predicting all-cause mortality among overweight or obese patients.
• Continued use of LAV indexed to BSA is supported for prognosis in this population.
• The current normal range of <34 mL/m² for LAV/BSA is appropriate.