Abstract 4241: Left Atrial Minimum Volume Is The Most Powerful Predictor Of Adverse Cardiovascular Events.

Abstract

Objective: we sought to identify, among all two-dimensional (2D), Doppler and three-dimensional (3D) echocardiography variables, the best predictor of adverse cardiovascular events in a 4 years follow-up study. Methods: A population of 151 consecutive sinus rhythm outpatients (mean age 57 ± 15 years) with cardiovascular risk factors, free from previous cardiovascular events or valvular heart disease, underwent 2D, Doppler and 3D echocardiography; data were indexed by body surface area. After a mean follow up of 54 ± 3 months, the study population was divided in two subgroups according to the subsequent development of cardiovascular events (death, myocardial infarction and stroke) or not. Results: combined endpoint was reached in 28 patients (18%). These patients showed significant differences for: e/e′ ratio (p<0.001), end systolic and end diastolic left ventricular (LV) diameters (p<0.05), 2D ejection fraction (p<0.01), 3D LV end diastolic (p<0.01) and end systolic volume (p<0.01), 3D LV mass (p<0.001) and ejection fraction (p<0.01), 3D left atrial maximum (p<0.001) and minimum volumes (p<0.001). By Cox Proportional Hazard analysis we were able to identify left atrial minimum volume as the best independent predictor of cumulative events (hazard ratio: 1.286, confidence interval 1.056 to 1.565; p=0.012). Kaplan-Meier analysis allowed to highlight statistically significant differences among tertiles of 3D left atrial minimum volume in terms of combined endpoint (p=0.002; Figure ). Conclusion: left atrial minimum volume obtained by 3D echocardiography, was in our selected population, the most powerful independent predictor of adverse cardiovascular events.