title: Left atrial volume index: a predictor of adverse outcome in patients with hypertrophic cardiomyopathy.
abstract: BACKGROUND
  Despite the relatively benign course for the majority of patients with hypertrophic cardiomyopathy (HCM), this disease may cause sudden cardiac death and progressive heart failure (HF). The aim of this study was to investigate useful parameters for predicting adverse outcomes of HCM, including echocardiographic parameters, cardiac magnetic resonance (CMR), and clinical markers.
  
  
  METHODS
  Eighty-one patients with nonapical HCM (51 men; mean age, 57 +/- 14 years) who underwent CMR and echocardiography were prospectively evaluated. Cardiovascular events were defined as hospitalization for worsening HF, stroke, or cardiovascular death.
  
  
  RESULTS
  During the mean follow-up period of 41 +/- 17 months, there were 17 cardiovascular events (5 deaths, 7 hospitalizations for worsening HF, and 5 strokes). Univariate analysis showed that older age, atrial fibrillation, elevated E/E' ratio, increased left atrial (LA) volume index, presence of mitral regurgitation grade > 2, New York Heart Association class III or IV, and late gadolinium enhancement >or= 6% were associated with cardiovascular events. In multivariate Cox regression analysis, increased LA volume index was found to be an independent predictor of cardiovascular events (for each 5 mL/m(2) increase, hazard ratio, 1.28; 95% confidence interval, 1.10-1.48; P < .01). Increased LA volume index was also revealed to be an independent predictor for cardiovascular events other than death (for each 5 mL/m(2) increase, hazard ratio, 1.44; 95% confidence interval, 1.12-1.83; P < .01).
  
  
  CONCLUSIONS
  LA volume index is independently associated with adverse outcomes in patients with HCM and provides additional prognostic information.
authors.affiliation: Cardiology Division, Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Woo-In
authors.initials: WI
authors.lastname: Yang
authors.forename: Chi Young
authors.initials: CY
authors.lastname: Shim
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Sung-Ai
authors.initials: SA
authors.lastname: Kim
authors.forename: Sang Jae
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Eui-Young
authors.initials: EY
authors.lastname: Choi
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Seung-Yun
authors.initials: SY
authors.lastname: Cho
authors.forename: Jong-Won
authors.initials: JW
authors.lastname: Ha
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000000981:diagnostic imaging* / Q000401:mortality*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D017063:Outcome Assessment, Health Care / Q000379:methods*; D015995:Prevalence; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate