Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women

Tsang, Teresa S.M.; Barnes, Marion E.; Bailey, Kent R.; Leibson, Cynthia L.; Montgomery, Samantha C.; Takemoto, Yasuhiko; Diamond, Pauline; Marra, Marisa A.; Gersh, Bernard J.; Wiebers, David O.; Petty, George W.; Seward, James B.

doi:10.4065/76.5.467

Cited by 570 publications

(418 citation statements)

References 29 publications

Supporting

Mentioning

371

Contrasting

Unclassified

Order By: Relevance

“…Stroke volume was calculated by multiplying the LV outflow tract area with the LV outflow tract velocity time integral. Left atrial volume was measured in LV end‐systole by Simpson's biplane method in apical 2‐ and 4‐chamber views and indexed to BSA 8, 9. LV filling pressures were estimated by E/e′ ratio 10.…”

Section: Methodsmentioning

confidence: 99%

Impact of Mean Transaortic Pressure Gradient on Long‐Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

Bohbot

Kowalski

Ruşinaru

et al. 2017

JAHA

View full text Add to dashboard Cite

BackgroundMean transaortic pressure gradient (MTPG) has never been validated as a predictor of mortality in patients with severe aortic stenosis. We sought to determine the value of MTPG to predict mortality in a large prospective cohort of severe aortic stenosis patients with preserved left ventricular ejection fraction and to investigate the cutoff of 60 mm Hg, proposed in American guidelines.Methods and ResultsA total of 1143 patients with severe aortic stenosis defined by aortic valve area ≤1 cm2 and MTPG ≥40 mm Hg were included. The population was divided into 3 groups according to MTPG: between 40 and 49 mm Hg, between 50 and 59 mm Hg, and ≥60 mm Hg. The end point was all‐cause mortality. MTPG was ≥60 mm Hg in 392 patients. Patients with MTPG ≥60 mm Hg had a significantly increase risk of mortality compared with patients with MTPG <60 mm Hg (hazard ratio [HR]=1.62 [1.27–2.05] P<0.001), even for the subgroup of asymptomatic or minimally symptomatic patients (HR=1.56 [1.04–2.34] P=0.032). After adjustment for established outcome predictors, patients with MTPG ≥60 mm Hg had a significantly higher risk of mortality than patients with MTPG <60 mm Hg (HR=1.71 [1.33–2.20] P<0.001), even after adjusting for surgery as a time‐dependent variable (HR=1.71 [1.43–2.11] P<0.001). Similar results were observed for the subgroup of asymptomatic or minimally symptomatic patients (HR=1.70 [1.10–2.32] P=0.018 and HR=1.68 [1.20–2.36] P=0.003, respectively).ConclusionsThis study shows the negative prognostic impact of high MTPG (≥60 mm Hg), on long‐term outcome of patients with severe aortic stenosis with preserved left ventricular ejection fraction, irrespective of symptoms.

show abstract

Section: Methodsmentioning

confidence: 99%

Impact of Mean Transaortic Pressure Gradient on Long‐Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

Bohbot

Kowalski

Ruşinaru

et al. 2017

JAHA

View full text Add to dashboard Cite

show abstract

“…[311][312][313][314][315][316] In the absence of MVD, an increase in LA size most commonly reflects increased wall tension as a result of increased LA pressure, [317][318][319][320] as well as impairment in LA function secondary to atrial myopathy. 321,322 A clear relationship exists between an enlarged LA and the incidence of atrial fibrillation and stroke, [323][324][325][326][327][328][329][330][331][332] risk for overall mortality after myocardial infarction, 321,322,333,334 risk for death and hospitalization in patients with dilated cardiomyopathy, [335][336][337][338][339][340][341][342][343][344] and major cardiac events or death in patients with diabetes mellitus. 345 left atrium enlargement is a marker of both the severity and chronicity of diastolic dysfunction and magnitude of LA pressure elevation.…”

Section: Imaging Techniques To Detect Atrial Cardiomyopathies Mappingmentioning

confidence: 99%

“…347 For assessment of atrial size, most widely reported is the linear dimension in the parasternal long-axis view using M-mode or 2 delayed enhancement (DE). [324][325][326][327][328][329][330][331][332][333][334][335][336][337][338][339]345,[347][348][349] However, due to the complex 3D nature of the atrium and the non-uniform nature of atrial remodelling, this measurement frequently does not provide an accurate picture of LA size. 350 -354 Thus, when assessing LA size and remodelling, the measurement of LA volume is a more powerful prognostic indicator in a variety of cardiac disease states.…”

Section: Echocardiographymentioning

confidence: 99%

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

et al. 2016

View full text Add to dashboard Cite

“…23,24 There is accumulating evidence that the association between cardiovascular disease and LAV/body surface area (LAVI) is stronger than that observed with LAD/body surface area (LADI) after adjustment for age and gender in subjects with sinus rhythm. 17,[23][24][25] Therefore, we assessed the relationships between plasma HCII activity and the LA size parameters. We found a significant inverse correlation between plasma HCII activity and LAVI, as well as LADI even after adjustment for other confounding cardiovascular risk factors, suggesting that HCII independently counteracts LA enlargement.…”

Section: Discussionmentioning

confidence: 99%

Plasma heparin cofactor II activity is inversely associated with left atrial volume and diastolic dysfunction in humans with cardiovascular risk factors

et al. 2010

View full text Add to dashboard Cite

Thrombin has a crucial role in cardiac remodeling through protease-activated receptor-1 activation in cardiac fibroblasts and cardiomyocytes. As heparin cofactor II (HCII) inhibits the action of tissue thrombin in the cardiovascular system, it is possible that HCII counteracts the development of cardiac remodeling. We investigated the relationships between plasma HCII activity and surrogate markers of cardiac geometry, including left atrial volume index (LAVI), relative wall thickness (RWT) and left ventricular mass index, and deceleration time (DcT) and the ratio of peak E velocity to early diastolic mitral annulus velocity (E/e' ratio) as surrogate markers of left ventricular diastolic dysfunction measured using echocardiography in 304 Japanese elderly individuals without systolic heart failure (169 men and 135 women; mean age: 65.4±11.8 years). Mean plasma HCII activity in all participants was 95.8±17.0% and there was no difference between the mean plasma HCII activities in males and females. Multiple regression analysis revealed that there were significant inverse relationships between plasma HCII activity and LAVI (coefficient: À0.2302, Po0.001), between HCII activity and RWT (coefficient: À0.0007, Po0.05), between HCII activity and DcT (coefficient: À0.5189, Po0.05) and between HCII activity and E/e' ratio (coefficient: À0.0558, Po0.01). Plasma HCII activity was independently and inversely associated with the development of cardiac remodeling, including cardiac concentric change, left atrial enlargement and left ventricular diastolic dysfunction. These findings suggest that cardiac tissue thrombin inactivation by HCII is a novel therapeutic target for cardiac remodeling and atherosclerosis.

show abstract

Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women

Cited by 570 publications

References 29 publications

Impact of Mean Transaortic Pressure Gradient on Long‐Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

Impact of Mean Transaortic Pressure Gradient on Long‐Term Outcome in Patients With Severe Aortic Stenosis and Preserved Left Ventricular Ejection Fraction

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

Plasma heparin cofactor II activity is inversely associated with left atrial volume and diastolic dysfunction in humans with cardiovascular risk factors

Contact Info

Product

Resources

About