Prognostic Value of Left Atrial Functional Measures in Heart Failure With Reduced Ejection Fraction

Daniel Modin*, Morten Sengeløv, Peter Godsk Jørgensen, Flemming Javier Olsen, Niels Eske Bruun, Thomas Fritz-Hansen, Ditte Madsen Andersen, Jan Skov Jensen, Tor Biering-Sørensen

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    BACKGROUND: The prognostic value of LA functional measures in heart failure patients with reduced ejection fraction (HFrEF) is unclear. Therefore, this study investigated the prognostic value of left atrial (LA) functional measures such as the left atrial emptying fraction (LAEF) and the minimal LA volume compared with left atrial volume index (LAVI) in HFrEF patients.

    METHODS AND RESULTS: A total of 818 HFrEF patients with left ventricular ejection fractions <45% underwent echocardiography. LA volumes were determined by the area-length method from the apical 2-chamber and apical 4-chamber views. LAEF, minimal LA volume indexed to body surface area (MinLAVI), and LAVI were calculated. The end point was all-cause mortality. During a median follow-up of 3.3 years (interquartile range 1.8-4.6 years), 121 patients died (14.8%). Follow-up was 100%. In a final multivariable model adjusting for clinical and echocardiographic parameters, LAEF, but not MinLAVI or LAVI, was an independent predictor of all-cause mortality in HFrEF patients: LAEF: hazard ratio (HR) 1.11 (P = .033) per 5% decrease; MinLAVI: HR 1.03 (P = .57) per 5 mL/m 2 increase; LAVI: HR 1.06 (P = .16) per 5 mL/m 2 increase.

    CONCLUSIONS: LAEF is an independent predictor of all-cause mortality in HFrEF patients after multivariable adjustment. LAEF provides incremental prognostic value over LAVI in risk stratification of HFrEF patients.

    OriginalsprogEngelsk
    Sider (fra-til)87-96
    Antal sider10
    TidsskriftJournal of Cardiac Failure
    Vol/bind25
    Udgave nummer2
    DOI
    StatusUdgivet - feb. 2019

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