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

JOURNAL OF CARDIAC FAILURE

卷:25

Article

Modin, Daniel¹  Sengelov, Morten¹  Jorgensen, Peter Godsk¹  Olsen, Flemming Javier¹  Bruun, Niels Eske^1,3  Fritz-Hansen, Thomas¹  Andersen, Ditte Madsen¹  Jensen, Jan Skov^1,2  Biering-Sorensen, Tor¹ 

[1] Univ Copenhagen, Herlev & Gentofte Hosp, Dept Cardiol, Niels Andersensvej 65,Post 835, DK-2900 Copenhagen, Denmark

[2] Univ Copenhagen, Fac Hlth Sci, Inst Clin Med, Copenhagen, Denmark

[3] Aalborg Univ, Clin Inst, Aalborg, Denmark

关键词: Heart failure with reduced ejection fraction;    left atrial function;    prognosis;    risk stratification;    mortality;    echocardiography;   

DOI  :  10.1016/j.cardfail.2018.11.016

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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