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. 2017 Jan-Mar;27(1):1-6.
doi: 10.4103/2211-4122.199064.

Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction

Omar Issa  1 , Julio G Peguero  1 , Carlos Podesta  1 , Denisse Diaz  2 , Javier De La Cruz  2 , Daniela Pirela  2 , Juan Carlos Brenes  1
Affiliations

Left Atrial Size and Heart Failure Hospitalization in Patients with Diastolic Dysfunction and Preserved Ejection Fraction

Omar Issa et al. J Cardiovasc Echogr. 2017 Jan-Mar.

Abstract

Context: Heart failure with preserved ejection fraction (HFpEF) is a clinical syndrome associated with diastolic function abnormalities. It remains unclear which factors, if any, can predict the transition from asymptomatic diastolic dysfunction to an overt symptomatic phase.

Materials and methods: Patients hospitalized with suspected heart failure between January 2012 and November 2014 with a transthoracic echocardiogram demonstrating preserved systolic function were screened (n = 425). Patients meeting the American College of Cardiology Foundation/American Heart Association definition for HFpEF (n = 40) were matched in a 1:1 fashion to individuals admitted for hypertensive urgency with diastolic dysfunction and neither pulmonary edema nor history of heart failure (n = 40). The clinical records and echocardiograms of all eighty patients included in this retrospective study were reviewed.

Results: Patients with HFpEF had higher body mass index (BMI), creatinine, beta-blocker use, and Grade 2 diastolic dysfunction when compared to the hypertensive control population. Echocardiographic analysis demonstrated higher right ventricular systolic pressures, left ventricular mass index, E/A, and E/e' in patients with HFpEF. Similarly, differences were observed in most left atrial (LA) parameters including larger LA maximum and minimum volume indices, as well as smaller LA-emptying fractions in the heart failure group. Multivariate logistic regression analysis revealed LA minimum volume index (odds ratio [OR]: 1.23 [1.09-1.38], P = 0.001) to have the strongest association with heart failure hospitalization after adjustment for creatinine (OR: 7.09 [1.43-35.07], P = 0.016) and BMI (OR: 1.11 [0.99-1.25], P = 0.074).

Conclusion: LA minimum volume index best correlated with HFpEF in this patient cohort with diastolic dysfunction.

Keywords: Diastolic dysfunction; heart failure with preserved ejection fraction; left atrium.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Association between left atrial minimum volume index and heart failure hospitalization in the overall population.
See this image and copyright information in PMC

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