Key result
An enlarged left atrial volume index (> 34 ml/m2) was independently associated with an increased risk of all-cause mortality (HR 2.009) in patients with degenerative mitral stenosis.
Why the study?
Degenerative mitral stenosis carries a poor prognosis, but beyond mean transmitral gradient, little is known about the association between other echocardiographic parameters and prognosis.
Does an enlarged left atrial volume index predict all-cause mortality in patients with degenerative mitral stenosis?
Cohort (n=155)
Yes
Does an enlarged left atrial volume index predict all-cause mortality in patients with degenerative mitral stenosis?
In patients with degenerative mitral stenosis, an enlarged left atrial volume index (> 34 ml/m2) is an independent predictor of all-cause mortality.
Answers are grounded in this paper and cite their sources.
May support risk stratification in degenerative mitral stenosis; leaves open whether LAVI-guided interventions improve outcomes.
PURPOSE: Degenerative mitral stenosis (DMS) is associated with a poor prognosis. Although mean transmitral gradient (TMG) has shown a good correlation with outcome, little is known about the association between other echocardiographic parameters and prognosis in patients with DMS. The current study aimed to evaluate the prognostic value of left atrial volume index (LAVI) in patients with DMS. METHODS: A total of 155 patients with DMS (72[63-80] years, 67% female) were included. The population was divided according to LAVI: normal-sized LAVI (LAVI ≤ 34 ml/m2); and enlarged LAVI (> 34 ml/m2). RESULTS: Patients with enlarged LAVI had a higher left ventricular mass index (120[96-146] vs. 91[70-112] g/m2 p < 0.001), as well as a higher prevalence of significant mitral regurgitation and severe aortic stenosis (23% vs. 10% p = 0.046 and 38% vs. 15% p=0.001, respectively) compared to patients with normal-sized LAVI. During a median follow-up of 25 months, 56 (36%) patients died. Patients with enlarged LAVI had worse prognosis compared to patients with normal-sized LAVI (p = 0.026). In multivariable Cox regression model, an enlarged LAVI was independently associated with all-cause mortality (HR 2.009, 95% CI 1.040 to 3.880, P = 0.038). CONCLUSION: An enlarged LAVI (> 34 ml/m2) is significantly associated with excess mortality in patients with DMS. After adjusting for potential confounders, an enlarged LAVI was the only parameter that remained independently associated with prognosis.
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Yedidya et al. (2022) conducted a cohort in Degenerative mitral stenosis (n=155). Enlarged left atrial volume index (> 34 ml/m2) vs. Normal-sized left atrial volume index (≤ 34 ml/m2) was evaluated on All-cause mortality (HR 2.009, 95% CI 1.040-3.880, p=0.038). An enlarged left atrial volume index (> 34 ml/m2) was independently associated with an increased risk of all-cause mortality (HR 2.009) in patients with degenerative mitral stenosis.
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