Cardiovascular Ultrasound (Nov 2011)

Left atrial volume predicts adverse cardiac and cerebrovascular events in patients with hypertrophic cardiomyopathy

  • Tani Tomoko,
  • Yagi Toshikazu,
  • Kitai Takeshi,
  • Kim Kitae,
  • Nakamura Hitomi,
  • Konda Toshiko,
  • Fujii Yoko,
  • Kawai Junichi,
  • Kobori Atsushi,
  • Ehara Natsuhiko,
  • Kinoshita Makoto,
  • Kaji Shuichiro,
  • Yamamuro Atsushi,
  • Morioka Shigefumi,
  • Kita Toru,
  • Furukawa Yutaka

DOI
https://doi.org/10.1186/1476-7120-9-34
Journal volume & issue
Vol. 9, no. 1
p. 34

Abstract

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Abstract Aims To prospectively evaluate the relationship between left atrial volume (LAV) and the risk of clinical events in patients with hypertrophic cardiomyopathy (HCM). Methods We enrolled a total of 141 HCM patients with sinus rhythm and normal pump function, and 102 patients (73 men; mean age, 61 ± 13 years) who met inclusion criteria were followed for 30.8 ± 10.0 months. The patients were divided into two groups with or without major adverse cardiac and cerebrovascular events (MACCE), a composite of stroke, sudden death, and congestive heart failure. Detailed clinical and echocardiographic data were obtained. Results MACCE occurred in 24 patients (18 strokes, 4 congestive heart failure and 2 sudden deaths). Maximum LAV, minimum LAV, and LAV index (LAVI) corrected for body surface area (BSA) were significantly greater in patients with MACCE than those without MACCE (maximum LAV: 64.3 ± 25.0 vs. 51.9 ± 16.0 ml, p = 0.005; minimum LAV: 33.9 ± 15.1 vs. 26.2 ± 10.9 ml, p = 0.008; LAVI: 40.1 ± 15.4 vs. 31.5 ± 8.7 ml/mm2, p = 0.0009), while there were no differences in the other echocardiographic parameters. LAV/BSA of ≥ 40.4 ml/m2 to identify patients with cardiovascular complications with a sensitivity of 73% and a specificity of 88%. Conclusion LAVI may be an effective marker for detecting the risk of MACCE in patients with HCM and normal pump function.

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