Prognostic value of reduction in left atrial size during a follow-up of heart failure: an observational study
Open Access
- 19 February 2021
- Vol. 11 (2), e044409
- https://doi.org/10.1136/bmjopen-2020-044409
Abstract
Objective The association between sequential changes in left atrial diameter (LAD) and prognosis in heart failure (HF) remains to be elucidated. The present study aimed to investigate the link between reduction in LAD and clinical outcomes in patients with HF. Design A multicentre prospective cohort study. Setting This study was nested from the Kyoto Congestive Heart Failure registry including consecutive patients admitted for acute decompensated heart failure (ADHF) in 19 hospitals throughout Japan. Participants The current study population included 673 patients with HF who underwent both baseline and 6-month follow-up echocardiography with available paired LAD data. We divided them into two groups: the reduction in the LAD group (change Primary and secondary outcomes The primary outcome measure was a composite of all-cause death or hospitalisation for HF during 180 days after 6-month follow-up echocardiography. The secondary outcome measures were defined as the individual components of the primary composite outcome measure and a composite of cardiovascular death or hospitalisation for HF. Results The cumulative 180-day incidence of the primary outcome measure was significantly lower in the reduction in the LAD group than in the no-reduction in the LAD group (13.3% vs 22.2%, p=0.002). Even after adjusting 15 confounders, the lower risk of reduction in LAD relative to no-reduction in LAD for the primary outcome measure remained significant (HR 0.59, 95% CI 0.36 to 0.97 p=0.04). Conclusion Patients with reduction in LAD during follow-up after ADHF hospitalisation had a lower risk for a composite endpoint of all-cause death or HF hospitalisation, suggesting that the change of LAD might be a simple and useful echocardiographic marker during follow-up.This publication has 33 references indexed in Scilit:
- The Global Health and Economic Burden of Hospitalizations for Heart FailureJournal of the American College of Cardiology, 2014
- Left Atrial Size and FunctionJournal of the American College of Cardiology, 2014
- Left Atrial Size Is a Potent Predictor of Mortality in Mitral Regurgitation Due to Flail LeafletsCirculation: Cardiovascular Imaging, 2011
- Heart failure reversal by ventricular unloading in patients with chronic cardiomyopathy: criteria for weaning from ventricular assist devicesEuropean Heart Journal, 2010
- Global 2-Dimensional Strain as a New Prognosticator in Patients With Heart FailureJournal of the American College of Cardiology, 2009
- Left atrial remodelling in patients with myocardial infarction complicated by heart failure, left ventricular dysfunction, or both: the VALIANT Echo StudyEuropean Heart Journal, 2008
- Long-term prognostic significance of left atrial volume in acute myocardial infarctionJournal of the American College of Cardiology, 2004
- Left Atrial Size and the Risk of Stroke and DeathCirculation, 1995
- Echocardiographic predictors of nonrheumatic atrial fibrillation. The Framingham Heart Study.Circulation, 1994
- Estimation of left ventricular filling pressures using two-dimensional and Doppler echocardiography in adult patients with cardiac disease: Additional value of analyzing left atrial size, left atrial ejection fraction and the difference in duration of pulmonary venous and mitral flow velocity at atrial contractionJournal of the American College of Cardiology, 1993