Moderate to severe left atrial dilation (LAVi ≥42 ml/m2) significantly increased the risk of adverse cardiovascular events (aHR 1.47) compared to no or mild dilation in patients with atrial fibrillation.
Observational (n=489)
No
Do left and right atrial echocardiographic parameters predict adverse cardiovascular outcomes in patients with atrial fibrillation?
Left atrial volume index and indexed left atrial antero-posterior diameter enhance risk prediction for adverse cardiovascular outcomes in patients with atrial fibrillation.
Effect estimate: aHR 1.47 (95% CI 1.03-2.09)
Absolute Event Rate: 35.7% vs 19.2%
p-value: p=0.033
BACKGROUND: This study evaluates the association between left atrial and right atrial (LA, RA) parameters and a composite endpoint (CEP) of all-cause death, thromboembolism, acute coronary syndrome, and heart failure hospitalization in atrial fibrillation (AF) patients. MATERIAL AND METHODS: Patients were prospectively enrolled. At baseline, the following echocardiogram parameters were measured: LA and RA antero-posterior diameter index (iLAAPD, iRAAPD), LA and RA volume index (LAVi, RAVi), LA and RA sphericity index (LASI, RASI), LA and RA emptying fraction. RESULTS: A total of 489 patients (61.3% males) with a median age of 75 (66-80) years and a median CHA2DS2VASc score of 3 (2-5) were enrolled (92.2% receiving anticoagulation). Permanent AF was present in 40.5% of the total cohort. After a median follow-up of 1114 (392-1384) days, 129 patients (26.3%) reached the CEP. The highest sensitivity for CEP was for LA emptying fraction 24 mm/m2 (72% and 73%, respectively) while the best negative predictive values were for iLAAPD and LAVi (both 81%). Right atrial parameters were not associated with CEP. Discrimination analysis using net reclassification improvement (NRI) showed that iLAAPD and LAVi significantly improved patient reclassification compared to a null model without atrial parameters (iLAAPD NRI 0.30; P = 0.005; LAVi NRI 0.32; P = 0.002). Multivariate Cox regression analysis found that LA dimensions, volume, and function were associated with a higher risk of adverse outcomes and significantly improved risk prediction for the CEP. CONCLUSIONS: LAVi and iLAAPD enhance discrimination and risk prediction for adverse outcomes in AF patients.
Mantovani et al. (Tue,) conducted a observational in Atrial fibrillation (n=489). Moderate to severe left atrial dilation (LAVi ≥42 ml/m2) vs. No or mild left atrial dilation (LAVi <42 ml/m2) was evaluated on Composite of all-cause death, stroke or systemic embolism, acute coronary syndrome, and hospitalization for new/worsening heart failure (aHR 1.47, 95% CI 1.03-2.09, p=0.033). Moderate to severe left atrial dilation (LAVi ≥42 ml/m2) significantly increased the risk of adverse cardiovascular events (aHR 1.47) compared to no or mild dilation in patients with atrial fibrillation.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: