title: Increased left atrial volume index predicts a poor prognosis in patients with heart failure.
abstract: 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.
  
  
  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).
  
  
  CONCLUSIONS
  LAVI may be useful for stratification of risk in patients with HF.
authors.affiliation: Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
authors.forename: Harutoshi
authors.initials: H
authors.lastname: Tamura
authors.forename: Tetsu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishiyama
authors.forename: Shintaro
authors.initials: S
authors.lastname: Sasaki
authors.forename: Takanori
authors.initials: T
authors.lastname: Arimoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Shishido
authors.forename: Takehiko
authors.initials: T
authors.lastname: Miyashita
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Joji
authors.initials: J
authors.lastname: Nitobe
authors.forename: Osamu
authors.initials: O
authors.lastname: Hirono
authors.forename: Isao
authors.initials: I
authors.lastname: Kubota
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016279:Atrial Function, Left / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging*; D006333:Heart Failure / Q000175:diagnosis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014463:Ultrasonography