Left Atrial Volume Index Over Late Diastolic Mitral Annulus Velocity (LAVi/A′) Is a Useful Echo Index to Identify Advanced Diastolic Dysfunction and Predict Clinical Outcomes
Version of Record online: 6 FEB 2011
© 2011 Wiley Periodicals, Inc.
Volume 34, Issue 2, pages 124–130, February 2011
How to Cite
Park, H.-J., Jung, H. O., Min, J., Park, M. W., Park, C. S., Shin, D. I., Shin, W.-S., Kim, P. J., Youn, H.-J. and Seung, K.-B. (2011), Left Atrial Volume Index Over Late Diastolic Mitral Annulus Velocity (LAVi/A′) Is a Useful Echo Index to Identify Advanced Diastolic Dysfunction and Predict Clinical Outcomes. Clin Cardiol, 34: 124–130. doi: 10.1002/clc.20850
- Issue online: 4 FEB 2011
- Version of Record online: 6 FEB 2011
- Manuscript Accepted: 22 SEP 2010
- Manuscript Received: 7 AUG 2010
Combined interpretation of late diastolic mitral annulus velocity (A′) with left atrial volume index (LAVi) may have additional benefits in the assessment of diastolic dysfunction.
The LAVi/A′ ratio may be useful in the identifying advanced diastolic dysfunction (ADD) and predicting clinical outcomes in patients with dyspnea.
We enrolled 395 consecutive patients hospitalized with dyspnea (New York Heart Association class II–IV) and performed transthoracic Doppler echocardiography and B-type natriuretic peptide (BNP) measurement. LAVi/A′ values were evaluated in terms of diagnosing ADD and predicting clinical outcome.
On the receiver operation characteristic curve analysis for the determination of ADD, the area under the curves of LAVi/A′ in the entire population was comparable to those of BNP (0.94 vs 0.93, P = 0.845) and mitral E/E′ (0.94 vs 0.93, P = 0.614) and higher than that of LAVi (0.94 vs 0.87; P = 0.014). A LAVi/A′ of 4.0 was the best cut-off value to identify ADD. During a median follow-up of 31.9 months (range, 0.3 to 45.7 months), the group with LAVi/A′ ≥4.0 had a higher incidence of primary composite outcomes (cardiac death and/or rehospitalization for heart failure) than the group with LAVi/A′<4.0 (25.0% vs 3.3%, P < 0.001). LAVi/A′ ≥4.0 was an independent predictor of clinical outcomes (odds ratio, 3.245; 95% confidence interval, 1.386–7.598; P = 0.007).
As a new echo index, LAVi/A′ is a useful parameter to identify ADD and predict clinical outcomes in patients with dyspnea. Copyright © 2011 Wiley Periodicals, Inc.
The authors have no funding, financial relationships, or conflicts of interest to disclose.