Increased left and right atrial volume indices are associated with decreased survival times post-cardiac arrest

Ibrahim, Sami; Bilchick, Kenneth C.; Miller, Matthew; Blazek, O; Strickling, Jarred; Elumogo, Comfort; Wharton, Robert; Patel, Paras; Ondigi, Olivia; Brady, William J.; Kwon, Younghoon; Mazimba, Sula

doi:10.1016/j.resuscitation.2021.10.023

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…RLR is an easily accessible measurement on 2D TTE, which is standard of care before TMVr, and has been shown to be reliable with minimal interobserver variability. 9 , 24 , 26 The results of the current study suggest that preprocedural RAVI/LAVI could play a valuable role in patient selection and risk stratification for TMVr and provide added insight beyond risk stratification scores such as STS and EuroScore.…”

Section: Discussionmentioning

confidence: 82%

“…PH has been associated with adverse outcomes in many cardiovascular conditions 23 . On the other hand, RLR is also associated with adverse outcomes in patients with PH, 24 cardiogenic shock, 8 and in hospital cardiac arrest 9 . Studies have demonstrated the independent association of PH with adverse outcomes following TMVr 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Another interesting finding from our study was the paradoxical relationship between elevated LAVI and improved outcomes 23 On the other hand, RLR is also associated with adverse outcomes in patients with PH, 24 cardiogenic shock, 8 and in hospital cardiac arrest. 9 Studies have demonstrated the independent association of PH with adverse outcomes following TMVr. 25 As such the potential mechanism underling our findings of increased mortality following TMVr with elevated RLR could be related to the influence of PH on outcomes.…”

Section: Cox Proportional-hazard Regression Modelmentioning

confidence: 99%

“…Structural changes in atrial dimension/volumes are often a reflection of pressure and volume changes occurring in the ventricles. It has been previously shown that increased right to left atrial volume indices (RAVI and LAVI) portends worse outcomes in patients with pulmonary hypertension (PH), 8 cardiogenic shock, 8 and in hospital cardiac arrest 9 . LAVI in particular is gaining recognition as an indicator of overall cardiac function, and has been termed “the HbA1c of the heart.” 10 There is limited evidence regarding the prognostic implications of RAVI and LAVI in patients undergoing TMVr.…”

Section: Introductionmentioning

confidence: 99%

“…It has been previously shown that increased right to left atrial volume indices (RAVI and LAVI) portends worse outcomes in patients with pulmonary hypertension (PH), 8 cardiogenic shock, 8 and in hospital cardiac arrest. 9 LAVI in particular is gaining recognition as an indicator of overall cardiac function, and has been termed “the HbA1c of the heart.” 10 There is limited evidence regarding the prognostic implications of RAVI and LAVI in patients undergoing TMVr. This study sought to investigate the relationship between RAVI and LAVI with all‐cause mortality among patients undergoing TMVr at a single academic medical center.…”

Section: Introductionmentioning

confidence: 99%

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Right atrial structural remodeling predict worse outcomes in transcatheter mitral valve repair

Miller

Cutts

Donatelle

et al. 2022

Cathet Cardio Intervent

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Background In the current study, we assess the predictive role of right and left atrial volume indices (RAVI and LAVI) as well as the ratio of RAVI/LAVI (RLR) on mortality following transcatheter mitral valve repair (TMVr). Methods Transthoracic echocardiograms of 158 patients who underwent TMVr at a single academic medical center from 2011 to 2018 were reviewed retrospectively. RAVI and LAVI were calculated using Simpson's method. Patients were stratified based on etiology of mitral regurgitation (MR). Cox proportional‐hazard regression was created utilizing MR type, STS‐score, and RLR to assess the independent association of RLR with survival. Kaplan−Meier analysis was used to analyze the association between RAVI and LAVI with all‐cause mortality. Hemodynamic values from preprocedural right heart catheterization were also compared between RLR groups. Results Among 123 patients included (median age 81.3 years; 52.5% female) there were 50 deaths during median follow‐up of 3.0 years. Patients with a high RAVI and low LAVI had significantly higher all‐cause mortality while patients with high LAVI and low RAVI had significantly improved all‐cause mortality compared to other groups (p = 0.0032). RLR was significantly associated with mortality in patients with both functional and degenerative MR (p = 0.0038). Finally, Cox proportion‐hazard modeling demonstrated that an elevated RLR above the median value was an independent predictor of all‐cause mortality [HR = 2.304; 95% CI = 1.26−4.21, p = 0.006] when MR type and STS score were accounted for. Conclusion Patients with a high RAVI and low LAVI had significantly increased mortality than other groups following TMVr suggesting RA remodeling may predict worse outcomes following the procedure. Concordantly, RLR was predictive of mortality independent of MR type and preprocedural STS‐score. These indices may provide additional risk stratification in patients undergoing evaluation for TMVr.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Cox Proportional-hazard Regression Modelmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Right atrial structural remodeling predict worse outcomes in transcatheter mitral valve repair

Miller

Cutts

Donatelle

et al. 2022

Cathet Cardio Intervent

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View full text Add to dashboard Cite

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The HbA1C of the heart: Atrial volume index and outcomes of cardiac arrest

Lloyd

2022

Resuscitation

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Left atrial volume index and non-ischemic myocardial contrast pattern as a predictor of continued left ventricular remodeling in patients with ischemic cardiomyopathy: magnetic resonance imaging data

Shelkovnikova,

Andreev,

Maksimova

et al. 2024

Russ J Cardiol

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Aim. To evaluate the heart morphological features and the significance of the non-ischemic myocardial contrast pattern in medium-term prognosis of continued left ventricular (LV) remodeling after surgery in patients with ischemic cardiomyopathy.Material and methods. The results of paramagnetic contrast-enhanced cardiac magnetic resonance imaging (MRI) were analyzed in 31 patients with ischemic cardiomyopathy with an average age of 58,4±7,6 years before complex surgical treatment. The heart morphological features and non-ischemic contrast pattern in the myocardial segments remote from the infarction area according to contrast-enhanced MRI were assessed.Results. Patients with a non-ischemic contrast pattern had higher left atrial volume index (p=0,02), LV end-systolic index (p=0,03), and right ventricular sizes (p=0,01). A relationship was found between the left atrial volume index and cardiac remodeling in the postoperative period (p<0,005, correlation coefficient r=0,53).Conclusion. Non-ischemic myocardial contrast pattern is accompanied by an increase in the left atrial volume, which in turn is a predictor of continued LV remodeling in patients with ischemic cardiomyopathy in the postoperative period.

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Increased left and right atrial volume indices are associated with decreased survival times post-cardiac arrest

Cited by 5 publications

References 28 publications

Right atrial structural remodeling predict worse outcomes in transcatheter mitral valve repair

Right atrial structural remodeling predict worse outcomes in transcatheter mitral valve repair

The HbA1C of the heart: Atrial volume index and outcomes of cardiac arrest

Left atrial volume index and non-ischemic myocardial contrast pattern as a predictor of continued left ventricular remodeling in patients with ischemic cardiomyopathy: magnetic resonance imaging data

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