Left atrial size may predict exercise capacity and cardiovascular events: In patients with heart failure
Texas Heart Institute Journal, cilt.35, sa.2, ss.136-143, 2008 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 35 Sayı: 2
- Basım Tarihi: 2008
- Dergi Adı: Texas Heart Institute Journal
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.136-143
- Anahtar Kelimeler: Atrial function, left/physiology, Cardiac output, Cardiomegaly, dilated/ultrasonography, Diastole, Exercise test, Exercise tolerance/physiology, Exertion, Heart atria, Heart failure, Myocardial contraction, Predictive value of tests, Prognosis, ROC curve
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Our aim was to investigate, in patients with heart failure, the relationship between left atrial size and exercise capacity and cardiovascular events. Seventy-five patients (67 men and 8 women; mean age, 53.4 ± 8.8 yr) with left ventricular ejection fractions of ≤0.45 (New York Heart Association functional classes I-III) were matched by age and sex with 20 healthy control subjects. Echocardiographic examinations were performed, as was exercise testing by the modified Bruce protocol. Patients were monitored for a period of 330 to 480 days for cardiac death or for heart failure that required hospitalization. The indexed left atrial diastolic size ( β level = -0.534, P <0.001) and left ventricular late diastolic filling velocity ( β level = 0.247, P <0.017) were the most important values in predicting low exercise capacity. The only independent predictor of low exercise capacity (<5 METS) was the indexed left atrial diastolic size (odds ratio, 1.428; 95% confidence interval, 1.09-1.702; P <0.001). Every 1 mm/m2 increase in indexed left atrial diastolic dimension caused a 42.8% increase in the risk of severe heart failure (exercise capacity, <5 METS). Independent predictors for cardiovascular events were indexed as left atrial systolic size (odds ratio, 1.383; 95% confidence interval, 1.145-1.671; P <0.001) and left ventricular early diastolic/ late diastolic filling velocity (odds ratio, 1.096; 95% confidence interval, 1.010-1.189; P <0.027). Indexed left atrial diastolic and left atrial systolic size predict exercise capacity and cardiovascular events, respectively, in New York Heart Association functional class I through III heart failure patients. © 2008 by the Texas Heart® Institute.