Increased Left Atrial Volume Index: Potent Biomarker for First-Ever Ischemic Stroke

Fatema, Kaniz; Bailey, Kent R.; Petty, George W.; Meissner, Irene; Osranek, Martin; Alsaileek, Ahmed; Khandheria, Bijoy K.; Tsang, Teresa S.M.; Seward, James B.

doi:10.4065/83.10.1107

Cited by 58 publications

(44 citation statements)

References 44 publications

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“…23 In addition, LA volume index is a powerful predictor of stroke in AF. 24,25 In general, LA size may be a marker of the state of vasculature as it also predicts adverse cardiovascular outcomes regardless of AF. 26,27 Although echocardiography remains the most commonly used modality for the volumetric assessment2…”

Section: La Size and Shapementioning

confidence: 99%

Atrial Fibrillation Pathophysiology and Prognosis

Siontis

Gersh

2015

Circ: Cardiovascular Imaging

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Section: La Size and Shapementioning

confidence: 99%

Atrial Fibrillation Pathophysiology and Prognosis

Siontis

Gersh

2015

Circ: Cardiovascular Imaging

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“…15 left atrial Volume assessment Left atrial volume was measured using the modified biplane area-length method and was corrected for body surface area. 16,17 The LAVI was categorized as either normal (≤28 mL/m 2 ) or increased (mild, 29-33 mL/m 2 ; moderate, 34-39 mL/m 2 ; severe, ≥40 mL/m 2 ). 13 statistical analyses All statistical analyses were performed with SAS statistical software, version 9.1 (SAS Institute, Cary, NC).…”

confidence: 99%

Left Atrial Volume Index Predictive of Mortality Independent of Left Ventricular Geometry in a Large Clinical Cohort With Preserved Ejection Fraction

Patel¹,

Lavie²,

Milani³

et al. 2011

Mayo Clinic Proceedings

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Objective: To determine the effect on mortality of the left atrial volume index (LAVI) and left ventricular (LV) geometry (normal, concentric remodeling, eccentric hypertrophy, and concentric hypertrophy). ReSultS: Progressive increases in LAVI and mortality were noted with abnormal LV geometry. Similarly, abnormal LV geometry and mortality were significantly higher in patients with increased LAVI.In patients who died vs surviving patients, the LAVI ± SD was significantly higher (33.0±14.8 vs 28.1±10.8 mL/m 2 ; P<.001) and abnormal LV geometry was significantly more prevalent (62% vs 44%; P<.001). Compared with those with a normal LAVI, patients with a severe LAVI had a 42% increased risk of mortality. In patients with normal LV geometry or concentric remodeling, a severe LAVI was a significant independent predictor of mortality, with an increased risk of 28% and 46%, respectively. Similarly, in patients with eccentric hypertrophy and concentric hypertrophy, the mortality risk in patients with a severe LAVI was twice that of patients with a normal LAVI. Comparison of area under the curve (0.565 [without LAVI] vs 0.596 [with LAVI]; P<.001] and predictive models with and without LAVI for mortality prediction were significant, indicating increased mortality prediction by the addition of LAVI to other independent predictors. cONcluSiON: The LAVI significantly predicts mortality risk, independent of LV geometry, and adds to the overall mortality prediction in a large cohort of patients with preserved systolic function. Mayo Clin © 2011 Mayo Foundation for Medical Education and ResearchL eft ventricular (LV) geometry, as an expression of the structural adaptation to an increased cardiovascular (CV) risk factor burden, is a well-known predictor of CV morbidity and mortality. [1][2][3][4][5] These structural changes in the left ventricle also lead to functional impairment, notably impaired LV filling, thereby facilitating the development of diastolic dysfunction 6 and ultimately leading to left atrial (LA) enlargement (LAE). 7 The left atrium is directly exposed to LV pressure during diastole through the open mitral valve, and therefore any morphologic changes in the left atrium are largely determined by the same factors that influence diastolic LV filling.8 Recent studies have shown that LA volume increases with the severity of diastolic dysfunction and may express long-term exposure to abnormal LV filling pressures, providing a more sensitive and stable morphophysiologic expression of LV diastolic dysfunction. 9Current evidence strongly suggests that LA size, as assessed by echocardiography, is strongly associated with mortality.7,10-12 However, it is still unknown whether LAE predicts mortality independent of LV geometry and also whether it provides additional prognostic information to that of other predictors of mortality in a large cohort of patients with preserved systolic function.To address this gap in the literature, we conducted a study of a large clinical cohort of 36,561 patients with preserved LV ejection ...

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“…The LAVI may be significantly elevated in a variety of conditions. It is most frequently increased in atrial fibrillation, brain stroke, coronary artery disease, heart failure, renal failure, and diabetes mellitus [16][17][18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Correlation analysis of the relationship between B-type natriuretic peptide and selected echocardiographic parameters in patients with permanent pacemakers

Sielski¹,

Grabowska²,

Kaziród-Wolski³

et al. 2015

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Key words: B-type natriuretic peptide, cardiac pacing, left atrial volume index.Słowa kluczowe: peptyd natriuretyczny typu B, stymulacja serca, indeks objętości lewego przedsionka. AbstractIntroduction: The present study was undertaken to evaluate the practical value of BNP measurements and echocardiographic left ventricular volume index in patients with permanent pacemakers because there are no such reports in the literature. Aim of the research: The aim of the study was to reveal multiple correlations between BNP levels and selected echocardiographic parameters of the left atrium in patients with permanent pacemakers. In the literature there are reports on the significance of BNP values and left atrial size in patients with permanent pacemakers. The results of the present study appear to be of value in the outpatient assessment of these patients. Material and methods:We analysed a group of 117 patients with permanent pacemakers (AAI/R 21 patients, DDD/R 59 patients, VVI/R 37 patients) and 48 healthy volunteers serving as the control group. BNP measurements were performed on venous blood samples using Triage meters. The Simpson method and the ellipse method were used to assess the left atrium on echocardiography. Results: There was a significant correlation between BNP and maximum left atrial volume, minimum left atrial volume, and left atrial volume index in patients with AAI/R, DDD/R, and VVI/R pacemakers at 3 and 6 months after the implantation. Conclusions: In patients after implantation of permanent pacemakers there are correlations between BNP values and echocardiographic left atrial parameters, especially in patients with DDD/R pacemakers. Left atrial function improves in patients with DDD/R pacemakers. Pacemaker check-up should be extended to include BNP measurements and echocardiographic assessment of the left atrium.

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Increased Left Atrial Volume Index: Potent Biomarker for First-Ever Ischemic Stroke

Cited by 58 publications

References 44 publications

Atrial Fibrillation Pathophysiology and Prognosis

Atrial Fibrillation Pathophysiology and Prognosis

Left Atrial Volume Index Predictive of Mortality Independent of Left Ventricular Geometry in a Large Clinical Cohort With Preserved Ejection Fraction

Correlation analysis of the relationship between B-type natriuretic peptide and selected echocardiographic parameters in patients with permanent pacemakers

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