| Right atrial volume index in chronic systolic heart failure and prognosis. | |
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MedLine Citation:
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PMID: 19442936 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of this study was to determine the relationship between right atrial volume index (RAVI) and right ventricular (RV) systolic and diastolic function, as well as long-term prognosis in patients with chronic systolic heart failure (HF). BACKGROUND: RV dysfunction is associated with poor prognosis in patients with HF, although echocardiographic assessment of RV systolic and diastolic dysfunction is challenging. The ability to visualize the RA allows a quantitative, highly reproducible assessment of the RA volume that can be indexed to body surface area. METHODS: The ADEPT (Assessment of Doppler Echocardiography for Prognosis and Therapy) trial enrolled 192 subjects with chronic systolic HF (left ventricular ejection fraction [LVEF] <or=35%). The RA volume was calculated by Simpson's method using single-plane RA area and indexed to body surface area (RAVI). RV systolic function was graded as normal, mild, mild-moderate, moderate, moderately severe, or severe dysfunction. RESULTS: In our study cohort, the mean RAVI was 28 +/- 15 ml/m(2), and increased with worsening RV systolic dysfunction, LVEF, and LV diastolic dysfunction (Spearman's r = 0.61, r = 0.26, and r = 0.51, respectively; p < 0.001 for all). RAVI correlated modestly with echocardiographic estimates of RV diastolic dysfunction, including tricuspid early/late velocities ratio (Spearman's r = 0.34, p < 0.0001), hepatic vein systolic/diastolic ratio (Spearman's r = -0.26, p < 0.001) but not tricuspid early/tricuspid annular early velocities ratio (E/Ea) (Spearman's r = 0.12, p = 0.11). Increasing tertiles of RAVI were predictive of death, transplant, and/or HF hospitalization (log-rank p = 0.0002) and remained an independent predictor of adverse clinical events after adjusting for age, B-type natriuretic peptide, LV ejection fraction, RV systolic dysfunction, and tricuspid E/Ea ratio (hazard ratio: 2.00, 95% confidence interval: 1.15 to 3.58, p = 0.013). CONCLUSIONS: In patients with chronic systolic HF, RAVI is a determinant of right-sided systolic dysfunction. This quantitative and reproducible echocardiographic marker provides independent risk prediction of long-term adverse clinical events. |
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Authors:
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John A Sallach; W H Wilson Tang; Allen G Borowski; Wilson Tong; Tama Porter; Maureen G Martin; Susan E Jasper; Kevin Shrestha; Richard W Troughton; Allan L Klein |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: JACC. Cardiovascular imaging Volume: 2 ISSN: 1876-7591 ISO Abbreviation: JACC Cardiovasc Imaging Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-15 Completed Date: 2009-07-24 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467978 Medline TA: JACC Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 527-34 Citation Subset: IM |
Affiliation:
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University of Michigan, Ann Arbor, Michigan, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Body Surface Area Chronic Disease Cohort Studies Echocardiography, Doppler* Female Heart Atria / ultrasonography* Heart Failure, Systolic / complications, mortality, physiopathology, ultrasonography* Heart Transplantation Hospitalization Humans Kaplan-Meiers Estimate Male Middle Aged Predictive Value of Tests Prognosis Proportional Hazards Models Reproducibility of Results Risk Assessment Severity of Illness Index Time Factors Ventricular Dysfunction, Left / etiology, mortality, physiopathology, ultrasonography* Ventricular Dysfunction, Right / etiology, mortality, physiopathology, ultrasonography* |
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