title: Increased right atrial volume index predicts low Duke activity status index in patients with chronic heart failure.
abstract: BACKGROUND
  The aim of the present study was to examine the value of the right atrial volume index (RAVI) as predictor of functional capacity in patients with heart failure.
  
  
  METHODS
  A total of 51 patients with stable chronic heart failure of ischaemic or non-ischaemic aetiology were prospectively enrolled. The systolic function of the right ventricle was quantified using the tricuspid annular plane systolic excursion (TAPSE). Right atrial volume was measured in the apical 4-chamber view and was indexed to body surface area. The functional capacity was assessed by the Duke Activity Status Index (DASI).
  
  
  RESULTS
  Patients with a low functional capacity (DASI<10) had lower TAPSE (1.4 ± 0.3 cm versus 2.0 ± 0.4 cm, p<0.001), higher RAVI (42 ± 15 ml/m(2) versus 22 ± 9 ml/m(2), p<0.001), higher estimated right ventricular systolic pressure (61 ± 13 mmHg versus 40 ± 16 mmHg, p<0.001), larger right ventricular end-diastolic diameter (4.7 ± 0.8 cm versus 3.6 ± 0.7 cm, p<0.001) and lower left ventricular ejection fraction (26 ± 6% versus 30 ± 7%, p=0.022). Multivariate analysis revealed that TAPSE was the single independent predictor of DASI. In the subgroup of patients with reduced right ventricular systolic function (TAPSE<2 cm), RAVI was the single independent predictor of low DASI. In the overall population RAVI=30.6 ml/m(2) had 75% sensitivity and 83% specificity in predicting DASI<10. Within the subgroup of patients with TAPSE<2 cm, RAVI=30.6 ml/m(2) had better sensitivity and specificity (79% and 90% respectively) in predicting DASI<10.
  
  
  CONCLUSIONS
  Increased right atrial volume index predicts low functional capacity quantified by the Duke Activity Status Index in patients with stable chronic heart failure.
authors: First Cardiology Department, AHEPA University Hospital, Thessaloniki, Greece. lmantziari@yahoo.com
authors: Lilian
authors: L
authors: Mantziari
authors: Vasileios
authors: V
authors: Kamperidis
authors: Ioannis
authors: I
authors: Ventoulis
authors: Efthalia
authors: E
authors: Damvopoulou
authors: Georgios
authors: G
authors: Giannakoulas
authors: Georgios
authors: G
authors: Efthimiadis
authors: Stelios
authors: S
authors: Paraskevaidis
authors: Vassilios
authors: V
authors: Vassilikos
authors: Antonios
authors: A
authors: Ziakas
authors: Haralambos
authors: H
authors: Karvounis
authors: Ioannis H
authors: IH
authors: Styliadis
mesh_terms: D000368:Aged; D016280:Atrial Function, Right / Q000502:physiology*; D002908:Chronic Disease; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D016278:Ventricular Function, Right / Q000502:physiology*