title: Prediction of All-Cause Mortality by the Left Atrial Volume Index in Patients With Normal Left Ventricular Filling Pressure and Preserved Ejection Fraction.
abstract: OBJECTIVE
  To describe the prevalence of left atrial (LA) enlargement (LAE) and its association with all-cause mortality in 10,719 patients with an early diastolic transmitral flow velocity (E) to early diastolic mitral annular velocity (e') ratio-determined normal left ventricular (LV) filling pressure and preserved LV ejection fraction (LVEF).
  
  
  METHODS
  We evaluated 10,719 patients (deceased patients: n = 479; mean [SD] age, 65 [14] years; 60% male; surviving patients: n = 10,240; mean (SD) age, 54 (16) years; 48% male) with estimated normal LV filling pressure (E/e' ratio ≤ 8) and preserved LVEF (≥ 50%) to determine the impact of LA volume index (LAVi) on all-cause mortality during a mean (SD) follow-up of 2.2 (1.0) years.
  
  
  RESULTS
  In the univariate analysis, with every milliliter per square meter increase in LAVi, all-cause mortality risk increased by 3% (hazard ratio [HR], 1.03; 95% CI, 1.02-1.04; P < .001). After adjusting for covariates, LAVi (as a continuous variable) was an independent predictor of all-cause mortality (HR, 1.015; 95% CI, 1.005-1.026; P = .01). When LAVi was assessed as a categorical variable with normal LAVi (≤ 28 mL/m(2)) as the reference group, moderate LAVi (34-39 mL/m(2)) and severe LAVi (≥ 40 mL/m(2)) were independent predictors of all-cause mortality (HR, 1.34; 95% CI, 1.01-1.79; P = .04; and HR, 1.65; 95% CI, 1.18-2.29; P = .003, respectively).
  
  
  CONCLUSIONS
  LAE was independently associated with an increased risk of all-cause mortality in our large cohort of 10,719 patients with normal LV filling pressure and preserved LVEF.
authors.affiliation: Division of Cardiovascular Medicine, UT Erlanger Cardiology - Erlanger Health System & University of Tennessee College of Medicine, Chattanooga, TN.
authors.forename: Dharmendrakumar A
authors.initials: DA
authors.lastname: Patel
authors.affiliation: Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University Of Queensland School of Medicine, New Orleans, LA; Department of Preventive Medicine, Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA. Electronic address: clavie@ochsner.org.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
authors.affiliation: Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University Of Queensland School of Medicine, New Orleans, LA.
authors.forename: Yvonne E
authors.initials: YE
authors.lastname: Gilliland
authors.affiliation: Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University Of Queensland School of Medicine, New Orleans, LA.
authors.forename: Sangeeta B
authors.initials: SB
authors.lastname: Shah
authors.affiliation: Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University Of Queensland School of Medicine, New Orleans, LA.
authors.forename: Homeyar K
authors.initials: HK
authors.lastname: Dinshaw
authors.affiliation: Department of Cardiovascular Diseases, The John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University Of Queensland School of Medicine, New Orleans, LA.
authors.forename: Richard V
authors.initials: RV
authors.lastname: Milani
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001783:Blood Flow Velocity; D015992:Body Mass Index; D002423:Cause of Death; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D014481:United States