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Prognostic Value of Left Atrial Volume in Patients with Dilated Cardiomyopathy

2013-11Journal article Open access
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dc.contributor.authorFerreira, F
dc.contributor.authorGalrinho, A
dc.contributor.authorSoares, R
dc.contributor.authorBranco, LM
dc.contributor.authorAbreu, J
dc.contributor.authorFeliciano, J
dc.contributor.authorPapoila, AL
dc.contributor.authorVirella, D
dc.contributor.authorLeal, A
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2020-02-07T13:31:54Z
dc.date.available2020-02-07T13:31:54Z
dc.date.issued2013-11
dc.description.abstractBACKGROUND: Increased left atrial (LA) size is a prognostic marker of mortality in the general population. LA size varies considerably in patients with dilated cardiomyopathy (DCM), but its clinical significance has not been widely studied. OBJECTIVE: To evaluate the long-term prognostic value of LA volume (LAV) in patients with DCM. METHODS: We prospectively studied patients admitted from January to December 2004 with a diagnosis of DCM, in sinus rhythm. Complete echocardiographic study at rest and after pharmacological stress was performed in all patients. The composite endpoint of mechanical ventricular assistance (MVA), heart transplantation or death during follow-up was assessed by univariate and multivariate analysis using a Cox regression model. RESULTS: The study population consisted of 35 patients (68.6% male, mean age 52.0) with DCM, 82.9% of non-ischemic etiology. Ejection fraction (EF) at rest was 31.1 ± 9.4%. During follow-up, eight patients died, one was placed on MVA and one underwent transplantation. Univariate Cox analysis showed various potential echocardiographic markers of prognosis in our population, including LA size in M-mode (HR 1.12, CI: 0.99-1.26, p=0.067), LAV (HR 1.03, CI: 1.00-1.07, p=0.046), LAV adjusted for body surface area (HR 1.03, CI: 0.99-1.26, p=0.049), E/A ratio (HR 0.99; CI: 0.99-1.81; p=0.060); E/A >2 (HR 7.00, CI: 1.48-32.43, p=0.014) and mitral E/E' ratio (HR 1.04, CI: 1.00-1.09, p=0.074). The only variable that remained in the multivariate model was LAV, with a cut-off value of 63 ml (HR 7.7, CI: 0.97-60.61, p=0.05). CONCLUSIONS: LAV was the only echocardiographic determinant of MVA, heart transplantation or death in our population with DCM. The echocardiographic parameters commonly used for risk stratification such as EF, left ventricular end-diastolic diameter and contractile reserve did not show prognostic significance in our study.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2013 Nov;32(11):865-72.pt_PT
dc.identifier.doi10.1016/j.repc.2012.12.017pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3435
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevier Españapt_PT
dc.subjectCardiomyopathy, Dilatedpt_PT
dc.subjectCohort Studiespt_PT
dc.subjectFemalept_PT
dc.subjectHeart Atriapt_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectOrgan Sizept_PT
dc.subjectPrognosispt_PT
dc.subjectSurvival Ratept_PT
dc.subjectHSM CARpt_PT
dc.subjectCHLC CINVpt_PT
dc.titlePrognostic Value of Left Atrial Volume in Patients with Dilated Cardiomyopathypt_PT
dc.title.alternativeO Volume da Aurícula Esquerda Como Marcador Ecocardiográfico de Prognóstico em Doentes Com Miocardiopatia Dilatadapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage872pt_PT
oaire.citation.issue11pt_PT
oaire.citation.startPage865pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume32pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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