Usefulness of left atrial volume index to predict heart failure hospitalization and mortality in ambulatory patients with coronary heart disease and comparison to left ventricular ejection fraction (from the heart and soul study)
Usefulness of left atrial volume index to predict heart failure hospitalization and mortality in ambulatory patients with coronary heart disease and comparison to left ventricular ejection fraction (from the heart and soul study)
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DOI：
10.1016/j.amjcard.2008.02.099
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发表时间：
2008-07-01
影响因子：
2.8
通讯作者：
Schiller, Nelson B.
中科院分区：
文献类型：
--
作者：
Ristow, Bryan;Ali, Sadia;Schiller, Nelson B.
冠状动脉疾病成人非卧床患者左房(LA)扩张的预测价值尚不清楚。假设超声心动图左房容量指数(LAVI)预测心力衰竭(HF)住院和死亡率的统计学作用与冠状动脉疾病成年患者的左心室射血分数(LVEF)相似。在心脏与灵魂研究中，我们测量了935名没有心房颤动、心房扑动或明显的二尖瓣疾病的成年人的LAVI。LAVI用圆盘双平面法计算。结果包括心衰住院和死亡率。计算Logistic回归优势比(OR)，并根据年龄、人口学特征、病史、左心室重量、舒张期功能和左心室射血分数进行调整。平均Lavi为32+/-11ml/m(2)，平均LVEF为62+/-10%。66例患者(7%)的Lavi&Gt；50ml/m(2)。在4.3年的随访中，有108人因心力衰竭住院，180人死亡。以受试者-操作者特征曲线下面积计算的C统计量，Lavi和LVEF在预测死亡率方面相同(0.60)。LAVI和GT组的HF住院未调整OR值为4.4%，LVEF40ml/m(2)组为5.3ml/m(2)，LVEF40ml/m(2)组的OR1.9，p=0.005。综上所述，LAVI与LVEF对成年冠状动脉疾病患者心力衰竭住院和死亡率的预测性相似。(C)2008 Elsevier Inc.保留所有权利。
The predictive value of left atrial (LA) dilatation in ambulatory adults with coronary artery disease is not known. It was hypothesized that echocardiographic LA volume index (LAVI) predicts heart failure (HF) hospitalization and mortality with similar statistical power as left ventricular ejection fraction (LVEF) in ambulatory adults with coronary artery disease. We measured LAVI in 935 adults without atrial fibrillation, atrial flutter, or significant mitral valve disease in the Heart and Soul Study. LAVI was calculated using the biplane method of disks. Outcomes included HF hospitalization and mortality. Logistic regression odds ratios (ORs) were calculated and adjusted for age, demographics, medical history, left ventricular mass, diastolic function, and LVEF. Mean LAVI was 32 +/- 11 ml/m(2) and mean LVEF was 62 +/- 10%. Sixty-six patients (7%) had LAVI>50 ml/m(2). There were 108 HF hospitalizations and 180 deaths at 4.3 years of follow-up. C statistics calculated as the area under the receiver-operator characteristic curve were the same (0.60) for LAVI and LVEF in predicting mortality. The unadjusted OR for HF hospitalization was 4.4 for LAVI>50 ml/m(2) and 5.3 for LVEF40 ml/m(2) was predictive of mortality (OR 1.9, p = 0.005). In conclusion, LAVI had similar predictability as LVEF for HF hospitalization and mortality in ambulatory adults with coronary artery disease. (C) 2008 Elsevier Inc. All rights reserved.