Left atrial volume index: a predictor of adverse outcome in patients with hypertrophic cardiomyopathy.
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.
Yang
Woo-In
WI
Cardiology Division, Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
Shim
Chi Young
CY
Kim
Young Jin
YJ
Kim
Sung-Ai
SA
Rhee
Sang Jae
SJ
Choi
Eui-Young
EY
Choi
Donghoon
D
Jang
Yangsoo
Y
Chung
Namsik
N
Cho
Seung-Yun
SY
Ha
Jong-Won
JW
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