Right atrial area larger than left atrial area was independently associated with all-cause mortality in elderly patients hospitalized for heart failure (adjusted HR 1.79; P=0.04).
Cohort (n=289)
Does a right atrial area larger than the left atrial area predict all-cause mortality in elderly patients hospitalized for heart failure?
An echocardiographic finding of a right atrium larger than the left atrium is an independent predictor of all-cause mortality in elderly patients hospitalized for heart failure.
Estimación del efecto: HR 1.79
valor p: p=0.04
BACKGROUND: While left atrial (LA) enlargement is known as an early sign of left heart disease with prognostic implications in heart failure (HF), the importance of right atrial (RA) enlargement is less well studied, and the prognostic implications of interatrial size comparison are insufficiently understood. The aim of this study was to test the hypothesis that RA area larger than LA area in apical four-chamber view is associated with all-cause mortality in elderly patients with HF independent of left ventricular ejection fraction (LVEF). METHODS: Retrospectively, 289 patients above 65 years hospitalized for HF between April 2007 and April 2008, and who underwent an echocardiogram, were enrolled. All-cause mortality was registered during a follow-up of at least 56 months. Baseline parameters measured were RA area, LA area, LA volume, LVEF, left ventricular mass (LVM), tissue Doppler systolic velocity of right ventricular free wall (SmRV), presence of severe tricuspid regurgitation (TR), tricuspid gradient, central venous pressure, systolic pulmonary artery pressure, as well as some parameters of diastolic function. RESULTS: In univariate analysis RA larger than LA was associated with all-cause mortality (hazard ratio HR of 1.88, P<.001). The relation of RA larger than LA to all-cause mortality remained even after adjusting for age, heart rate, LVEF, atrial fibrillation, percutaneous coronary intervention, LVM index, LA volume index, SmRV, and the presence of severe TR (HR: 1.79, P=.04). CONCLUSION: RA larger than LA, independently of LVEF, is associated with all-cause mortality in elderly patients hospitalized due to HF.
Almodares et al. (Tue,) conducted a cohort in Heart failure (n=289). Right atrial area larger than left atrial area vs. Right atrial area not larger than left atrial area was evaluated on All-cause mortality (HR 1.79, p=0.04). Right atrial area larger than left atrial area was independently associated with all-cause mortality in elderly patients hospitalized for heart failure (adjusted HR 1.79; P=0.04).