| ORIGINAL ARTICLE |
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| Year : 2017 | Volume
: 27
| Issue : 1 | Page : 1-6 |
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Left atrial size and heart failure hospitalization in patients with diastolic dysfunction and preserved ejection fraction
Omar Issa1, Julio G Peguero1, Carlos Podesta1, Denisse Diaz2, Javier De La Cruz2, Daniela Pirela2, Juan Carlos Brenes1
1 Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, FL, USA
2 Department of Internal Medicine, Mount Sinai Medical Center, Miami Beach, FL, USA
Correspondence Address:
Omar Issa
Columbia University Division of Cardiology, Mount Sinai Heart Institute, 4300 Alton Road, Miami Beach, FL 33140
USA
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/2211-4122.199064
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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. |
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