Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, Yamagata, Japan.
J Card Fail. 2011 Mar;17(3):210-6. doi: 10.1016/j.cardfail.2010.10.006. Epub 2010 Dec 3.
Left atrial volume index (LAVI) is known to reflect the duration and severity of increased left atrial pressure caused by left ventricular (LV) diastolic dysfunction. However, the prognostic value of LAVI in patients with heart failure (HF) has not been fully investigated.
Transthoracic echocardiography was performed in 146 consecutive patients (78 men, 68 women; mean age 72 ± 12 y) who were hospitalized for HF. There were 45 cardiac events (32%) during a median follow-up period of 448 days. There were no significant differences in LV end-diastolic dimensions or ejection fraction between patients who did or did not have cardiac events. However, LAVI was markedly higher in patients with, than those without, cardiac events (56 ± 26 vs 44 ± 22 mL/m(2); P < .01). Kaplan-Meier analysis showed that there was a stepwise increase in risk of cardiac events with each increment of LAVI category, and LAVI >53.3 mL/m(2) correlated with the highest risk of cardiac events (log-rank test; P < .01). Multivariate Cox proportional hazard analysis showed that high LAVI was an independent predictor for cardiac events (hazard ratio 1.427; 95% confidence interval 1.024-1.934; P < .05).
LAVI may be useful for stratification of risk in patients with HF.
左心房容积指数（LAVI）反映了左心室舒张功能障碍导致的左心房压力持续时间和严重程度。然而，LAVI 在心力衰竭（HF）患者中的预后价值尚未得到充分研究。
对 146 例连续住院的 HF 患者（78 例男性，68 例女性；平均年龄 72 ± 12 岁）进行了经胸超声心动图检查。中位随访 448 天期间发生 45 例心脏事件（32%）。有心脏事件和无心脏事件患者的 LV 舒张末期内径或射血分数无显著差异。然而，有心脏事件患者的 LAVI 明显高于无心脏事件患者（56 ± 26 比 44 ± 22 mL/m2；P <.01）。Kaplan-Meier 分析表明，随着 LAVI 类别的递增，心脏事件的风险呈逐步增加趋势，LAVI >53.3 mL/m2 与心脏事件的最高风险相关（对数秩检验；P <.01）。多变量 Cox 比例风险分析表明，高 LAVI 是心脏事件的独立预测因子（危险比 1.427；95%置信区间 1.024-1.934；P <.05）。
LAVI 可能有助于分层 HF 患者的风险。
