Journal of Cardiovascular Echography

ORIGINAL ARTICLE
Year
: 2017  |  Volume : 27  |  Issue : 1  |  Page : 1--6

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

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.


How to cite this article:
Issa O, Peguero JG, Podesta C, Diaz D, De La Cruz J, Pirela D, Brenes JC. Left atrial size and heart failure hospitalization in patients with diastolic dysfunction and preserved ejection fraction.J Cardiovasc Echography 2017;27:1-6


How to cite this URL:
Issa O, Peguero JG, Podesta C, Diaz D, De La Cruz J, Pirela D, Brenes JC. Left atrial size and heart failure hospitalization in patients with diastolic dysfunction and preserved ejection fraction. J Cardiovasc Echography [serial online] 2017 [cited 2022 Jan 19 ];27:1-6
Available from: https://www.jcecho.org/article.asp?issn=2211-4122;year=2017;volume=27;issue=1;spage=1;epage=6;aulast=Issa;type=0