Refereed journal article or data article (A1)

Prognostic value of left atrial volume index in degenerative mitral stenosis




List of Authors: Yedidya Idit, Butcher Steele C, Stassen Jan, van der Bijl Pieter, Ngiam Jinghao Nicholas, Chew Nicholas WS, Sia Ching-Hui, Leow Ryan, Li Tony Yi-Wei, Kong William KF, Poh Kian Keong, Kornowski Ran, Marsan Nina Ajmone, Delgado Victoria, Bax Jeroen J

Publisher: SPRINGER

Publication year: 2022

Journal: International Journal of Cardiovascular Imaging

Journal name in source: INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING

Journal acronym: INT J CARDIOVAS IMAG

Number of pages: 7

ISSN: 1569-5794

eISSN: 1573-0743

DOI: http://dx.doi.org/10.1007/s10554-022-02691-z

URL: https://link.springer.com/article/10.1007/s10554-022-02691-z

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/175916158


Abstract

Purpose

Degenerative mitral stenosis (DMS) is associated with a poor prognosis. Although mean transmitral gradient (TMG) has shown a good correlation with outcome, little is known about the association between other echocardiographic parameters and prognosis in patients with DMS. The current study aimed to evaluate the prognostic value of left atrial volume index (LAVI) in patients with DMS.

Methods

A total of 155 patients with DMS (72[63-80] years, 67% female) were included. The population was divided according to LAVI: normal-sized LAVI (LAVI <= 34 ml/m2); and enlarged LAVI (> 34 ml/m2).

Results

Patients with enlarged LAVI had a higher left ventricular mass index (120[96-146] vs. 91[70-112] g/m2 p < 0.001), as well as a higher prevalence of significant mitral regurgitation and severe aortic stenosis (23% vs. 10% p = 0.046 and 38% vs. 15% p=0.001, respectively) compared to patients with normal-sized LAVI. During a median follow-up of 25 months, 56 (36%) patients died. Patients with enlarged LAVI had worse prognosis compared to patients with normal-sized LAVI (p = 0.026). In multivariable Cox regression model, an enlarged LAVI was independently associated with all-cause mortality (HR 2.009, 95% CI 1.040 to 3.880, P = 0.038).

Conclusion

An enlarged LAVI (> 34 ml/m2) is significantly associated with excess mortality in patients with DMS. After adjusting for potential confounders, an enlarged LAVI was the only parameter that remained independently associated with prognosis.


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Last updated on 2022-12-08 at 12:31