title: Independent and incremental value of severely enlarged left atrium in risk stratification of very elderly patients with chronic systolic heart failure.
abstract: The authors sought to assess the impact on survival of demographic, clinical, and echo-Doppler parameters in patients with chronic heart failure due to left ventricular systolic dysfunction divided according to age groups. This study included 734 patients (age 69±11 years) who were classified into tertiles of age: I (22-66 years), II (67-76 years), and III (77-94 years). Severely enlarged left atrial size was defined as ≥52 mm in men and ≥47 mm in women. Multivariable analysis identified male sex (P=.018) and severely enlarged left atrium (P=.024) as significant correlates of all-cause mortality in the very elderly cohort, while restrictive filling pattern (RFP) (P=.004) and New York Heart Association class III or IV (P=.005) among patients of the first tertile and RFP (P=.028) among patients in the second tertile were independently associated with mortality after 30±21 months of follow-up. At the interactive stepwise model in the very elderly population, a severely enlarged left atrium, added to the model after clinical parameters and ejection fraction, moved the chi-square value from 20.7 to 25.8 (P=.048). RFP emerged as the single best predictor of all-cause mortality in the younger and intermediate ranges, whereas severely enlarged left atrium was the best predictor in the very elderly.
authors.affiliation: Service of Cardiology, Internal Medicine Clinic, University Clinical Centre of Kosova, Prishtina, Kosovoz. ganibajraktari@yahoo.co.uk
authors.forename: Gani
authors.initials: G
authors.lastname: Bajraktari
authors.forename: Paolo
authors.initials: P
authors.lastname: Fontanive
authors.forename: Spiro
authors.initials: S
authors.lastname: Qirko
authors.forename: Shpend
authors.initials: S
authors.lastname: Elezi
authors.forename: Anca
authors.initials: A
authors.lastname: Simioniuc
authors.forename: Alda
authors.initials: A
authors.lastname: Huqi
authors.forename: Venera
authors.initials: V
authors.lastname: Berisha
authors.forename: Frank L
authors.initials: FL
authors.lastname: Dini
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D054143:Heart Failure, Systolic / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018570:Risk Assessment / Q000379:methods*; D014463:Ultrasonography; D055815:Young Adult