Key result
LAVI >57 ml/m2 is linked to ~2.4-fold higher risk of adverse events in rheumatic mitral stenosis.
Why the study?
The significance of left atrial volume index (LAVI) for predicting outcomes in patients with mitral stenosis remained unclear.
Does an enlarged left atrial volume index predict adverse clinical events in patients with varying severities of rheumatic mitral stenosis?
Cohort (n=611)
No
Does an enlarged left atrial volume index predict adverse clinical events in patients with varying severities of rheumatic mitral stenosis?
The prognostic utility of the left atrial volume index in rheumatic mitral stenosis is highly dependent on disease severity, serving as a stronger predictor of outcomes in earlier stages (progressive MS).
Answers are grounded in this paper and cite their sources.
LAVI >57 ml/m² may aid risk stratification in progressive rheumatic MS; hypothesis-generating for severity-specific thresholds.
Background The significance of left atrial volume index (LAVI) for predicting outcomes in patients with mitral stenosis (MS) has been unclear, even though rheumatic MS is known to be associated with left atrium enlargement and functional deterioration. Hypothesis The current study aimed to investigate the prognostic value of LAVI, based on the severity in patients with rheumatic MS. Methods We retrospectively reviewed 611 patients with pure rheumatic MS. The prognostic value of LAVI and the effect of MS severity on the prognostic value of LAVI for events were evaluated. The events were defined as a composite end‐point that included all‐cause death, heart failure admission, mitral valve replacement, percutaneous mitral valvuloplasty, and stroke. Results There were 236 (38.6%) overall events during a median follow‐up of 8 months. The optimal LAVI cutoff for the prognostic threshold was 57 ml/m 2 . The MS severity had a significant effect on the prognostic value of LAVI. A LAVI >57 ml/m 2 was a prognostic value for events in progressive MS (hazard ratio [HR]: 2.40, 95% confidence interval [CI]: 1.41–5.40, p = .004) and in patients with severe MS (HR: 1.70, 95% CI: 1.06–2.74, p = .029), but it was not prognostic in patients with very severe MS (HR: 1.02, 95% CI: 0.56–1.84, p = .955). Conclusions The prognostic value of LAVI varies and is dependent on the MS severity. A LAVI >57 mL/m 2 was independently associated with poor outcomes in patients with progressive MS, while this association was minimized in patients with severe MS.
No takes yet. Share an insight, caveat, or question.
Cho et al. (2021) conducted a cohort in Rheumatic mitral stenosis (n=611). Left atrial volume index (LAVI) >57 ml/m2 vs. LAVI ≤57 ml/m2 was evaluated on Composite of all-cause death, heart failure admission, mitral valve replacement, percutaneous mitral valvuloplasty, and stroke (HR 2.40, 95% CI 1.41-5.40, p=0.004). Left atrial volume index >57 ml/m2 was independently associated with a 2.4-fold increased risk of adverse clinical events in patients with progressive rheumatic mitral stenosis.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: