title: Left Atrial Volume Determinants in Patients with Non-Ischemic Dilated Cardiomyopathy.
abstract: BACKGROUND
  Left atrial volume (LAV) is a predictor of prognosis in patients with heart failure.
  
  
  OBJECTIVE
  We aimed to evaluate the determinants of LAV in patients with dilated cardiomyopathy (DCM).
  
  
  METHODS
  Ninety patients with DCM and left ventricular (LV) ejection fraction ≤ 0.50 were included. LAV was measured with real-time three-dimensional echocardiography (eco3D). The variables evaluated were heart rate, systolic blood pressure, LV end-diastolic volume and end-systolic volume and ejection fraction (eco3D), mitral inflow E wave, tissue Doppler e' wave, E/e' ratio, intraventricular dyssynchrony, 3D dyssynchrony index and mitral regurgitation vena contracta. Pearson's coefficient was used to identify the correlation of the LAV with the assessed variables. A multiple linear regression model was developed that included LAV as the dependent variable and the variables correlated with it as the predictive variables.
  
  
  RESULTS
  Mean age was 52 ± 11 years-old, LV ejection fraction: 31.5 ± 8.0% (16-50%) and LAV: 39.2±15.7 ml/m2. The variables that correlated with the LAV were LV end-diastolic volume (r = 0.38; p < 0.01), LV end-systolic volume (r = 0.43; p < 0.001), LV ejection fraction (r = -0.36; p < 0.01), E wave (r = 0.50; p < 0.01), E/e' ratio (r = 0.51; p < 0.01) and mitral regurgitation (r = 0.53; p < 0.01). A multivariate analysis identified the E/e' ratio (p = 0.02) and mitral regurgitation (p = 0.02) as the only independent variables associated with LAV increase.
  
  
  CONCLUSIONS
  The LAV is independently determined by LV filling pressures (E/e' ratio) and mitral regurgitation in DCM.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Frederico José Neves
authors.initials: FJ
authors.lastname: Mancuso
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Valdir Ambrósio
authors.initials: VA
authors.lastname: Moisés
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Dirceu Rodrigues
authors.initials: DR
authors.lastname: Almeida
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Dalva
authors.initials: D
authors.lastname: Poyares
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Luciana Julio
authors.initials: LJ
authors.lastname: Storti
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Wércules Antonio
authors.initials: WA
authors.lastname: Oliveira
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Flavio Souza
authors.initials: FS
authors.lastname: Brito
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Angelo Amato Vincenzo de
authors.initials: AA
authors.lastname: Paola
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Antonio Carlos Camargo
authors.initials: AC
authors.lastname: Carvalho
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, BR.
authors.forename: Orlando
authors.initials: O
authors.lastname: Campos
mesh_terms: D000328:Adult; D016279:Atrial Function, Left / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology*; D002311:Cardiomyopathy, Dilated / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D018709:Statistics, Nonparametric; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology