Left Atrial Volume Determinants in Patients with Non-Ischemic Dilated
Cardiomyopathy |
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Authors: | Frederico José Neves Mancuso Valdir Ambrósio Moisés Dirceu Rodrigues Almeida Dalva Poyares Luciana Julio Storti Wércules Antonio Oliveira Flavio Souza Brito Angelo Amato Vincenzo de Paola Antonio Carlos Camargo Carvalho Orlando Campos |
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Institution: | 1.Disciplina de Cardiologia – EPM/UNIFESP, Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, SP - Brazil;2.Instituto do Sono - EPM/UNIFESP, Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo, SP - Brazil |
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Abstract: | BackgroundLeft atrial volume (LAV) is a predictor of prognosis in patients with heart
failure.ObjectiveWe aimed to evaluate the determinants of LAV in patients with dilated
cardiomyopathy (DCM).MethodsNinety patients with DCM and left ventricular (LV) ejection fraction ≤ 0.50 were
included. LAV was measured with real-time three-dimensional echocardiography
(eco3D). The variables evaluated were heart rate, systolic blood pressure, LV
end-diastolic volume and end-systolic volume and ejection fraction (eco3D), mitral
inflow E wave, tissue Doppler e´ wave, E/e´ ratio, intraventricular dyssynchrony,
3D dyssynchrony index and mitral regurgitation vena contracta. Pearson´s
coefficient was used to identify the correlation of the LAV with the assessed
variables. A multiple linear regression model was developed that included LAV as
the dependent variable and the variables correlated with it as the predictive
variables.ResultsMean age was 52 ± 11 years-old, LV ejection fraction: 31.5 ± 8.0% (16-50%) and
LAV: 39.2±15.7 ml/m2. The variables that correlated with the LAV were
LV end-diastolic volume (r = 0.38; p < 0.01), LV end-systolic volume (r = 0.43;
p < 0.001), LV ejection fraction (r = -0.36; p < 0.01), E wave (r = 0.50; p
< 0.01), E/e´ ratio (r = 0.51; p < 0.01) and mitral regurgitation (r = 0.53;
p < 0.01). A multivariate analysis identified the E/e´ ratio (p = 0.02) and
mitral regurgitation (p = 0.02) as the only independent variables associated with
LAV increase.ConclusionThe LAV is independently determined by LV filling pressures (E/e´ ratio) and
mitral regurgitation in DCM. |
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Keywords: | Heart Atria Organ Size Cardiomyopathy Dilated Chagas Cardiomyopathy Echocardiography Three-Dimensional |
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