TY - JOUR
T1 - Prognostic implications of small left atria on hospitalized patients
AU - Rozenbaum, Zach
AU - Topilsky, Yan
AU - Aviram, Galit
AU - Entin-Meer, Michal
AU - Granot, Yoav
AU - Pereg, David
AU - Berliner, Shlomo
AU - Steinvil, Arie
AU - Biner, Simon
N1 - Publisher Copyright:
© 2018 Published on behalf of the European Society of Cardiology. All rights reserved.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Aims: To demonstrate the association between small left atria (LA) and outcome in a relatively large heterogeneous population of hospitalized patients. Methods and results: In a single-centre retrospective study, all inpatients that underwent an echocardiographic assessment between 2011 and 2016 and had an available left atrial volume index (LAVI) measurement were included. The cohort consisted of 17 343 inpatients who had an available LAVI measurement, 288 with small LA (LAVI <16 mL/m2), 7531 patients had LAVI within normal limits (16-34 mL/m2) divided into low normal (16-24.9 mL/m2; n = 2636) and high normal (25-34 mL/m2; n = 4895), 4720 patients had large LAVI (34.1-45 mL/m2) and 4804 had very large LAVI (>45 mL/m2). Median follow-up time was 2.4 years. After adjustments for age, gender, and baseline characteristics with a P-value <0.2 in univariable analyses (body mass index, haemoglobin, ischaemic heart disease, valvulopathy, atrial fibrillation, diabetes mellitus, hypertension, hyperlipidaemia, smoking, renal dysfunction, lung disease, and malignancy) small LA was associated with a higher risk for in-hospital mortality (odds ratio 2.9, 95% confidence interval (CI) 1.4-5.7; P = 0.002] and all-cause mortality [hazard ratio (HR) 2.1, 95% CI 1.6-2.8; P < 0.001] compared with high normal LA. For every mL/m2 decrease below high normal LA size the risk for in-hospital and long-term all-cause mortality increased by 10% (HR 1.1, 95% CI 1.02-1.18; P = 0.005) and 8% (HR 1.08, 95% CI 1.05-1.12; P < 0.001), respectively. Conclusion: Small LA are independently associated poorer short- and long-term mortality. LA volume should be referred to as J-shaped in terms of mortality. Helsinki committee approval number: 0170-17-TLV.
AB - Aims: To demonstrate the association between small left atria (LA) and outcome in a relatively large heterogeneous population of hospitalized patients. Methods and results: In a single-centre retrospective study, all inpatients that underwent an echocardiographic assessment between 2011 and 2016 and had an available left atrial volume index (LAVI) measurement were included. The cohort consisted of 17 343 inpatients who had an available LAVI measurement, 288 with small LA (LAVI <16 mL/m2), 7531 patients had LAVI within normal limits (16-34 mL/m2) divided into low normal (16-24.9 mL/m2; n = 2636) and high normal (25-34 mL/m2; n = 4895), 4720 patients had large LAVI (34.1-45 mL/m2) and 4804 had very large LAVI (>45 mL/m2). Median follow-up time was 2.4 years. After adjustments for age, gender, and baseline characteristics with a P-value <0.2 in univariable analyses (body mass index, haemoglobin, ischaemic heart disease, valvulopathy, atrial fibrillation, diabetes mellitus, hypertension, hyperlipidaemia, smoking, renal dysfunction, lung disease, and malignancy) small LA was associated with a higher risk for in-hospital mortality (odds ratio 2.9, 95% confidence interval (CI) 1.4-5.7; P = 0.002] and all-cause mortality [hazard ratio (HR) 2.1, 95% CI 1.6-2.8; P < 0.001] compared with high normal LA. For every mL/m2 decrease below high normal LA size the risk for in-hospital and long-term all-cause mortality increased by 10% (HR 1.1, 95% CI 1.02-1.18; P = 0.005) and 8% (HR 1.08, 95% CI 1.05-1.12; P < 0.001), respectively. Conclusion: Small LA are independently associated poorer short- and long-term mortality. LA volume should be referred to as J-shaped in terms of mortality. Helsinki committee approval number: 0170-17-TLV.
KW - left atria
KW - mortality
KW - small
KW - volume index
UR - http://www.scopus.com/inward/record.url?scp=85071575374&partnerID=8YFLogxK
U2 - 10.1093/ehjci/jey230
DO - 10.1093/ehjci/jey230
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C2 - 30689832
AN - SCOPUS:85071575374
SN - 2047-2404
VL - 20
SP - 1051
EP - 1058
JO - European Heart Journal Cardiovascular Imaging
JF - European Heart Journal Cardiovascular Imaging
IS - 9
ER -