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Diastolic dysfunction and left atrial volume: a population-based study.

Abstract：

OBJECTIVES:We examined the association between diastolic function and left atrial volume indexed to body surface area (LAVi) in a population-based study. BACKGROUND:Atrial enlargement has been suggested as a marker of the severity and duration of diastolic dysfunction (DD). However, the association between DD and atrial enlargement and their individual prognostic implications in the population is poorly defined. METHODS:A cross-sectional sample of Olmsted County, Minnesota, residents > or =45 years of age (n=2,042) underwent comprehensive Doppler echocardiography and medical record review. RESULTS:The LAVi increased with worsening DD: 23 +/- 6 ml/m2 (normal), 25 +/- 8 ml/m2 (grade I DD), 31 +/- 8 ml/m2 (grade II DD), 48 +/- 12 ml/m2 (grades III to IV DD). In bivariate analyses, age, left ventricular mass index, and DD grade were positively associated, whereas female gender and ejection fraction (EF) were inversely associated with LAVi (p <0.001 for all). When controlling for age, gender, cardiovascular (CV) disease, EF, and left ventricular mass, grade II DD was associated with a 24%, and grade III to IV DD was associated with a 62% larger LA volume (p <0.0001 for both). The area under the receiver-operator characteristic curve for LAVi to detect grade I, grade II, or grade III to IV DD was 0.57, 0.81, and 0.98, respectively. Both DD and LAVi were predictive of all-cause mortality, but when controlling for DD, LAVi was not an independent predictor of mortality. CONCLUSIONS:These data suggest that DD contributes to LA remodeling. Indeed, DD is a stronger predictor of mortality; presumably it better reflects the impact of CV disease within the general population.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Pritchett AM,Mahoney DW,Jacobsen SJ,Rodeheffer RJ,Karon BL,Redfield MM

doi

10.1016/j.jacc.2004.09.054

subject

Has Abstract

pub_date

2005-01-04 00:00:00

pages

87-92

issue

1

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(04)01947-3

journal_volume

45

pub_type

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