Increased Left Atrial Volume Index Predicts a Poor Prognosis in Patients With Heart Failure
Increased Left Atrial Volume Index Predicts a Poor Prognosis in Patients With Heart Failure
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DOI：
10.1016/j.cardfail.2010.10.006
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发表时间：
2011-03-01
影响因子：
6
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Tamura, Harutoshi;Watanabe, Tetsu;Kubota, Isao
背景：左房容量指数(Lavi)是反映左室舒张功能不全所致左房压力升高的持续时间和严重程度的指标。方法和结果：146例因心力衰竭住院的患者(男78例，女68例；平均年龄72±12岁)接受了经胸超声心动图检查。在448天的中位随访期内，有45例心脏事件(32%)。在有或没有心脏事件的患者中，左室舒张末期内径或射血分数没有显著差异。然而，有心脏事件的患者的LAVI明显高于无心脏事件的患者(56+/-26比44+/-22毫升/米(2)；P<；0.01)。Kaplan-Meier分析显示，随着LAVI分级的增加，发生心脏事件的风险逐渐增加，Lavi&Gt；53.3m L/m(2)与心脏事件风险最高相关(log-ranking检验；P<；.01)。多变量COX比例风险分析显示，高LAVI是心脏事件的独立预测因子(危险性比1.427；95%可信区间1.024-1.934；P<；0.05)。结论：LAVI可用于心衰患者的风险分层。(J心力衰竭2011；17：210-216)
Background: Left atrial volume index (LAVI) is known to reflect the duration and severity of increased left atrial pressure caused by left ventricular (LV) diastolic dysfunction. However, the prognostic value of LAVI in patients with heart failure (HF) has not been fully investigated.Methods and Results: Transthoracic echocardiography was performed in 146 consecutive patients (78 men, 68 women; mean age 72 +/- 12 y) who were hospitalized for HF. There were 45 cardiac events (32%) during a median follow-up period of 448 days. There were no significant differences in LV end-diastolic dimensions or ejection fraction between patients who did or did not have cardiac events. However, LAVI was markedly higher in patients with, than those without, cardiac events (56 +/- 26 vs 44 +/- 22 mL/m(2); P < .01). Kaplan-Meier analysis showed that there was a stepwise increase in risk of cardiac events with each increment of LAVI category, and LAVI >53.3 mL/m(2) correlated with the highest risk of cardiac events (log-rank test; P < .01). Multivariate Cox proportional hazard analysis showed that high LAVI was an independent predictor for cardiac events (hazard ratio 1.427; 95% confidence interval 1.024-1.934; P < .05).Conclusion: LAVI may be useful for stratification of risk in patients with HF. (J Cardiac Fail 2011;17:210-216)