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Prognostic role of left atrial volume in elderly patients with symptomatic stable chronic heart failure: comparison with left ventricular diastolic dysfunction and B-type natriuretic peptide

Domenii publicaţii > Ştiinţe medicale + Tipuri publicaţii > Articol în revistã ştiinţificã

Autori: Popescu BA, Popescu AC, Antonini-Canterin F, Rubin D, Cappelletti P, Piazza R, Ginghina C, Dimulescu D, Beladan CC, Nicolosi GL.

Editorial: Echocardiography, 24(10), p.1035-1043, 2007.

Rezumat:

Background: Left atrial (LA) volume and B-type natriuretic peptide (BNP) represent powerful outcome predictors in patients with heart failure (HF). Aim: To assess the comparative prognostic role of LA volume (indexed to body surface area, LAVi), left ventricular diastolic dysfunction (LVDD) and BNP levels on long-term outcome in patients with symptomatic but stable chronic HF. Methods: We studied consecutively 46 patients with symptomatic stable chronic HF (73 ± 10 years, 30 men), in sinus rhythm, without significant valvular disease. Echocardiographic measurements included: LV mass, LV volumes and ejection fraction, and LAVi. LVDD was graded using a comprehensive Doppler algorithm. Blood taken before echocardiography was assayed for BNP levels. Primary end point was combined: all-cause mortality and hospitalization for worsening HF. Results: During 20 ± 14 months of follow-up 19 events occurred: 8 deaths, and 11 hospitalizations forHF. In univariate analyses LAVi, LVDD, BNP levels, LV ejection fraction, LV volumes, and LV mass were significant outcome predictors (P < 0.05). At multivariate regression LAVi was the only independent predictor of outcome (hazard ratio: 1.03 per 1 ml/m2 increase, 95% CI: 1.01�1.06, P = 0.02). Conclusion: Although directly related to LVDD and to BNP levels, only LAVi emerged as an independent outcome predictor in this cohort of elderly patients with symptomatic stable chronic HF.

Cuvinte cheie: left atrium, BNP, diastolic dysfunction, heart failure, echocardiography

URL: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1540-8175.2007.00540.x