title: Usefulness of left atrial volume in predicting first congestive heart failure in patients > or = 65 years of age with well-preserved left ventricular systolic function.
abstract: Left atrial (LA) volume is a barometer of diastolic dysfunction. Whether it predicts congestive heart failure (CHF) in patients with preserved left ventricular (LV) systolic function is not known. Olmsted County, Minnesota, residents aged > or = 65 years referred for transthoracic echocardiography from 1990 to 1998, who were in sinus rhythm without a history of CHF were followed in the medical records to 2003 (mean follow-up duration 4.3 +/- 2.7 years). Of the 1,495 patients identified, 1,375 (92%) with LV ejection fractions > or = 50% (mean age 75 +/- 7 years; 59% women) constituted the study population, 138 (10%) of whom developed CHF. Baseline LA volume > or = 32 ml/m2 was an independent predictor of first CHF (p <0.001). Of the 138 patients who had first CHF, ejection fractions were assessed within 4 weeks of diagnosis in 98 subjects, 74 (76%) of whom had ejection fractions remaining at > or = 50%, with a mean increase in LA volume of 8 +/- 10 ml/m2 (p <0.001) from baseline. The age-adjusted CHF-free survival rates for LA volume tertiles (< 28, 28 to < or = 37, and > 37 ml/m2) were 95%, 91%, and 83%, respectively (p <0.001). In conclusion, LA volume independently predicted first CHF in an elderly cohort with well-preserved LV systolic function.
authors.affiliation: Osaka City University of Medicine, Osaka, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Marion E
authors.initials: ME
authors.lastname: Barnes
authors.forename: James B
authors.initials: JB
authors.lastname: Seward
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Lester
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Appleton
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Kent R
authors.initials: KR
authors.lastname: Bailey
authors.forename: Teresa S M
authors.initials: TS
authors.lastname: Tsang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016279:Atrial Function, Left; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008910:Minnesota; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D016277:Ventricular Function, Left