Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta‐analysis of longitudinal data (MeRGE Heart Failure)

European Journal of Heart Failure - Tập 11 Số 10 - Trang 929-936 - 2009
Andrea Rossi1, Pier Luigi Temporelli2, Miguel Quintana3, Frank Lloyd Dini4, Stefano Ghio5, Graham S. Hillis6, Allan L. Klein7, Nina Ajmone Marsan5, David Prior8, Cheuk‐Man Yu9, Katrina Poppe10, Robert N. Doughty10, Gillian Whalley10
1Section of Cardiology, Department of Surgical and Biomedical Sciences University of Verona Ospedale Maggiore, Ple Stefani 1 37126 Verona Italy
2Divisione di Cardiologia Fondazione Salvatore Maugeri, IRCCS Veruno Italy
3Department of Cardiology The Karoliska Institute, Hospital de Torrevieja Spain
4Unità Malattie Cardiovascolari 2 Ospedale Santa Chiara Pisa Italy
5Divisione Di Cardiologia, Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
6The George Institute, University of Sydney, Sydney, Australia
7Cleveland Clinic Foundation, Cleveland, OH USA
8Cardiac Investigation Unit St Vincent's Hospital Melbourne Melbourne Australia
9Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
10Department of Medicine, FMHS, The University of Auckland, Auckland, New Zealand

Tóm tắt

AimsLeft atrial (LA) size is considered a marker of poor prognosis in heart failure (HF) patients. Prior studies have recruited relatively few subjects limiting their power to adequately analyse the interaction between LA size, left ventricular (LV) systolic and diastolic function, and prognosis.Method and resultsThe MeRGE collaboration combines prospective data from 18 studies in HF patients. In this analysis of data from 1157 patients, the primary endpoint was death or hospitalization for worsening HF. In multivariate analysis (Cox proportion hazard model), LA area was associated with prognosis (HR 1.03 per cm2, 95% CI 1.02, 1.05; P < 0.0001) independently of age, NYHA class, LV ejection fraction, and restrictive filling pattern (RFP). When LA area was used as a categorical variable, the HR associated with larger LA area (above median) was 1.4 (95% CI 1.13, 1.74) and when LA area index was used, the HR was 2.36 (95% CI 1.80, 3.08). When the patients with and without RFP were divided on the basis of either LA area or LA area index, significantly higher event rates were observed in those with larger LA area.ConclusionLeft atrial area is a powerful predictor of outcome among HF patients with predominantly impaired systolic function, and is independent of, and provides additional prognostic information beyond LV systolic and diastolic function.

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Thông tin xuất bản

European Journal of Heart Failure

Tập 11 Số 10

929-936

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