Severely enlarged left atrium was the best independent predictor of all-cause mortality in very elderly patients with chronic systolic heart failure (P=0.024).
Cohort (n=734)
Does a severely enlarged left atrium independently predict all-cause mortality in very elderly patients with chronic systolic heart failure?
Severely enlarged left atrium is the strongest echo-Doppler predictor of mortality in very elderly patients with systolic heart failure, while restrictive filling pattern is more predictive in younger patients.
p-value: p=0.024
The authors sought to assess the impact on survival of demographic, clinical, and echo-Doppler parameters in patients with chronic heart failure due to left ventricular systolic dysfunction divided according to age groups. This study included 734 patients (age 69±11 years) who were classified into tertiles of age: I (22-66 years), II (67-76 years), and III (77-94 years). Severely enlarged left atrial size was defined as ≥52 mm in men and ≥47 mm in women. Multivariable analysis identified male sex (P=.018) and severely enlarged left atrium (P=.024) as significant correlates of all-cause mortality in the very elderly cohort, while restrictive filling pattern (RFP) (P=.004) and New York Heart Association class III or IV (P=.005) among patients of the first tertile and RFP (P=.028) among patients in the second tertile were independently associated with mortality after 30±21 months of follow-up. At the interactive stepwise model in the very elderly population, a severely enlarged left atrium, added to the model after clinical parameters and ejection fraction, moved the chi-square value from 20.7 to 25.8 (P=.048). RFP emerged as the single best predictor of all-cause mortality in the younger and intermediate ranges, whereas severely enlarged left atrium was the best predictor in the very elderly.
Bajraktari et al. (2012) conducted a cohort in chronic heart failure due to left ventricular systolic dysfunction (n=734). Severely enlarged left atrium was evaluated on all-cause mortality (p=0.024). Severely enlarged left atrium was the best independent predictor of all-cause mortality in very elderly patients with chronic systolic heart failure (P=0.024).