The Association Between Baseline Left Atrial Volume Index and All-Cause Mortality in Patients with Heart Failure: A Meta-Analysis.
BACKGROUND
Enlargement of the left atrium is a marker of mortality in the general population. Left atrial volume index (LAVI) has long been proposed as a measure of prognosis in patients with heart failure (HF). The aim of this meta-analysis was to assess the utility of using baseline LAVI as an independent predictor of all-cause mortality in patients with HF.


METHODS
A search of Medline and Embase bibliographic databases was performed to identify studies meeting the following inclusion criteria: 1) studies evaluating a cohort of patients with HF (both reduced and preserved ejection fraction); 2) studies conducting multivariate analysis or patient matching to determine the relationship between baseline LAVI measured by echocardiography and all-cause mortality; and 3) studies reporting data on the relationship between baseline LAVI (per difference in mL/m2) and all-cause mortality. Adjusted hazard ratios depicting the association between baseline LAVI and all-cause mortality were pooled using traditional random-effects meta-analysis.


RESULTS
1,188 publications were reviewed from which four studies were included in the present meta-analysis. We found each 10 mL/m2 increase in baseline LAVI was associated with a 22% increased adjusted hazard of all-cause mortality (95% confidence interval, 13% to 31%, I2 = 14%).


CONCLUSIONS
Baseline LAVI is an important independent predictor of all-cause mortality in patients with heart failure and should be reported routinely in these patients undergoing echocardiography.
Bhavadharini
B
Ramu
Ahmed M
AM
Elwan
Craig I
CI
Coleman
David I
DI
Silverman
Jason A
JA
Gluck
D004452:Echocardiography; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology; D006333:Heart Failure / Q000000981:diagnostic imaging* / Q000401:mortality*; D006801:Humans