title: Relationship between left atrial volume and diastolic dysfunction in 500 Brazilian patients.
abstract: BACKGROUND
  Left atrial volume index (LAVI) increase has been associated to left ventricle (LV) diastolic dysfunction (DD), a marker of cardiovascular events (atrial fibrillation, stroke, heart failure, death).
  
  
  OBJECTIVE
  To evaluate the relationship between LAVI and diferente grades od DD in Brazilian patients submitted to echocardiogram, studying LAVI increase determinants in this sample.
  
  
  METHODS
  We have selected 500 outpatients submitted to echocardiography, after excluding arrhythmia, valvar or congenital cardiopathy, permanent pacemaker or inadequate ecocardiographic window. LAVI was obtained according to Simpson's method. DD was classified according to current guidelines. The clinical and echocardiographic variables were submitted to linear regression multivariate analysis.
  
  
  RESULTS
  Mean age was 52 ± 15 years old, 53% were male, 55% had arterial hypertension, 9% had coronary artery disease, 8% were diabetic, 24% were obese, 47% had LV hypertrophy. The mean ejection fraction of the left ventricle was 69.6 ± 7,2%. The prevalence of DD in this sample was 33.8% (grade I: 66%, grade II: 29% e grade III: 5%). LAVI increased progressively according to DD grade: 21 ± 4 mL/m² (absent), 26 ± 7 mL/m² (grade I), 33 ± 5 mL/m² (grade II), 50 ± 5 mL/m2 (grade III) (p < 0,001). In this sample, LAVI increase independent predictors were age, left ventricular mass, relative wall thickness, LV ejection fraction and E/e' ratio.
  
  
  CONCLUSIONS
  DD contributes to left atrial remodeling. LAVI increases as an expression of DD severity and is independently associated to age, left ventricle hypertrophy, systolic dysfunction and increased LV filling pressures.
authors.affiliation: Escola Paulista de Medicina-UNIFESP, São Paulo, SP, Brazil.
authors.forename: Lilia Maria Mameri
authors.initials: LM
authors.lastname: El Aouar
authors.forename: Diana
authors.initials: D
authors.lastname: Meyerfreud
authors.forename: Pedro
authors.initials: P
authors.lastname: Magalhães
authors.forename: Sérgio Lamêgo
authors.initials: SL
authors.lastname: Rodrigues
authors.forename: Marcelo Perim
authors.initials: MP
authors.lastname: Baldo
authors.forename: Yara
authors.initials: Y
authors.lastname: Brasil
authors.forename: Sumaya Mameri
authors.initials: SM
authors.lastname: El Aouar
authors.forename: Nabih Amin
authors.initials: NA
authors.lastname: El Aouar
authors.forename: José Geraldo
authors.initials: JG
authors.lastname: Mill
authors.forename: Orlando
authors.initials: O
authors.lastname: Campos Filho
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016279:Atrial Function, Left / Q000502:physiology*; D001938:Brazil; D003971:Diastole / Q000502:physiology; D004452:Echocardiography; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012016:Reference Values; D013318:Stroke Volume / Q000502:physiology*; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*; D055815:Young Adult