Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Department of Cardiovascular Medicine, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Clin Cardiol. 2021 Feb;44(2):222-229. doi: 10.1002/clc.23529. Epub 2020 Dec 9.
Clinical significance of left atrial (LA) function and geometry in patients with dilated cardiomyopathy (DCM) remains uncertain.
LA geometric parameters assessed by cardiac magnetic resonance (CMR) predict the prognosis in patients with DCM.
The present study included patients with DCM and sinus rhythm who underwent CMR between December 2007 and April 2018. LA volume was measured using CMR. LA sphericity index was computed as the ratio of the measured maximum LA volume by the volume of a sphere with maximum LA length diameter.
We included 255 patients in this study. During the mean follow-up of 3.92 years, hospitalization for HF occurred in 37 patients. The LA sphericity index was significantly higher in patients with hospitalization for HF than in those without (0.78 ± 0.35 vs. 0.58 ± 0.18, p < .001). Multivariable Cox regression analysis identified a higher LA sphericity index as an independent predictor of hospitalization for HF. Patients were categorized based on the median of LA sphericity index. The Kaplan-Meier curve showed that patients with a high LA sphericity index (≥0.57) had a significantly higher risk of hospitalization for HF than those with a low LA sphericity index (<0.57).
LA sphericity index was an independent predictor of hospitalization for HF. Assessment of LA geometric parameters might be useful for risk stratification in patients with DCM.
左心房（LA）功能和几何形状在扩张型心肌病（DCM）患者中的临床意义尚不确定。
心脏磁共振（CMR）评估的 LA 几何参数可预测 DCM 患者的预后。
本研究纳入了 2007 年 12 月至 2018 年 4 月期间接受 CMR 的 DCM 伴窦性节律患者。使用 CMR 测量 LA 容积。LA 球度指数通过 LA 最大长度直径的球体容积与测量的最大 LA 容积之比计算。
本研究共纳入 255 例患者。在平均 3.92 年的随访期间，37 例患者因 HF 住院。因 HF 住院的患者的 LA 球度指数明显高于未住院的患者（0.78±0.35 比 0.58±0.18，p<0.001）。多变量 Cox 回归分析确定较高的 LA 球度指数是 HF 住院的独立预测因子。根据 LA 球度指数的中位数将患者分类。Kaplan-Meier 曲线显示，LA 球度指数较高（≥0.57）的患者因 HF 住院的风险明显高于 LA 球度指数较低（<0.57）的患者。
LA 球度指数是 HF 住院的独立预测因子。评估 LA 几何参数可能有助于对 DCM 患者进行危险分层。
