Key result
Severe left atrial enlargement determined on routine cine-CMR was independently associated with an increased risk of all-cause mortality (HR 1.64) compared to normal left atrial volume.
Why the study?
Normal CMR left atrial volume reference values were lacking for US cohorts, and the prognostic association between grades of CMR-derived LA dilatation and outcomes was unestablished.
Does left atrial enlargement measured by routine cine-CMR predict all-cause mortality in patients referred for clinical CMR?
Population
10,890 patients undergoing clinically indicated CMR at three US centers and 85 healthy subjects
Comparison
Mild (52–62 ml/m2), moderate (63–73 ml/m2), and severe (>73 ml/m2) LAVi vs normal (21–52 ml/m2)
Design
Multicenter retrospective cohort study
Follow-up
Median 48.9 (IQR 32.1–71.2) months
Authors
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May inform prognosis on routine cine-CMR; leaves open incremental value beyond clinical predictors.
Cohort (n=10,890)
Yes
Does left atrial enlargement measured by routine cine-CMR predict all-cause mortality in patients referred for clinical CMR?
Effect estimate: HR 1.64 (95% CI 1.29 to 2.08)
Absolute Event Rate: 12.4% vs 6.1%
p-value: p=<0.001
Left atrial volume index determined on routine cine-CMR is independently associated with all-cause mortality in patients undergoing clinically indicated CMR.
Khan et al. (2019) conducted a cohort in Patients referred for routine cardiovascular magnetic resonance (n=10,890). Severe left atrial enlargement (LAVi > 73 ml/m2) vs. Normal left atrial volume (LAVi 21-52 ml/m2) was evaluated on All-cause mortality (HR 1.64, 95% CI 1.29 to 2.08, p=<0.001). Severe left atrial enlargement determined on routine cine-CMR was independently associated with an increased risk of all-cause mortality (HR 1.64) compared to normal left atrial volume.
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