Left Atrial Volume Index: A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy

Woo In Yang, ChiYoung Shim, Youngjin Kim, Sung Ai Kim, Sang Jae Rhee, Eui Young Choi, Donghoon Choi, Yangsoo Jang, Namsik Chung, Seung Yun Cho, Jong Won Ha

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Background: Despite the relatively benign course for the majority of patients with hypertrophic cardiomyopathy (HCM), this disease may cause sudden cardiac death and progressive heart failure (HF). The aim of this study was to investigate useful parameters for predicting adverse outcomes of HCM, including echocardiographic parameters, cardiac magnetic resonance (CMR), and clinical markers. Methods: Eighty-one patients with nonapical HCM (51 men; mean age, 57 ± 14 years) who underwent CMR and echocardiography were prospectively evaluated. Cardiovascular events were defined as hospitalization for worsening HF, stroke, or cardiovascular death. Results: During the mean follow-up period of 41 ± 17 months, there were 17 cardiovascular events (5 deaths, 7 hospitalizations for worsening HF, and 5 strokes). Univariate analysis showed that older age, atrial fibrillation, elevated E/E′ ratio, increased left atrial (LA) volume index, presence of mitral regurgitation grade > 2, New York Heart Association class III or IV, and late gadolinium enhancement ≥ 6% were associated with cardiovascular events. In multivariate Cox regression analysis, increased LA volume index was found to be an independent predictor of cardiovascular events (for each 5 mL/m 2 increase, hazard ratio, 1.28; 95% confidence interval, 1.10-1.48; P < .01). Increased LA volume index was also revealed to be an independent predictor for cardiovascular events other than death (for each 5 mL/m 2 increase, hazard ratio, 1.44; 95% confidence interval, 1.12-1.83; P < .01). Conclusion: LA volume index is independently associated with adverse outcomes in patients with HCM and provides additional prognostic information.

Original languageEnglish
Pages (from-to)1338-1343
Number of pages6
JournalJournal of the American Society of Echocardiography
Volume22
Issue number12
DOIs
Publication statusPublished - 2009 Dec 1

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Hypertrophic Cardiomyopathy
Heart Failure
Hospitalization
Magnetic Resonance Spectroscopy
Confidence Intervals
Sudden Cardiac Death
Gadolinium
Mitral Valve Insufficiency
Atrial Fibrillation
Echocardiography
Biomarkers
Stroke
Myocardial Infarction
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Yang, Woo In ; Shim, ChiYoung ; Kim, Youngjin ; Kim, Sung Ai ; Rhee, Sang Jae ; Choi, Eui Young ; Choi, Donghoon ; Jang, Yangsoo ; Chung, Namsik ; Cho, Seung Yun ; Ha, Jong Won. / Left Atrial Volume Index : A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy. In: Journal of the American Society of Echocardiography. 2009 ; Vol. 22, No. 12. pp. 1338-1343.
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abstract = "Background: Despite the relatively benign course for the majority of patients with hypertrophic cardiomyopathy (HCM), this disease may cause sudden cardiac death and progressive heart failure (HF). The aim of this study was to investigate useful parameters for predicting adverse outcomes of HCM, including echocardiographic parameters, cardiac magnetic resonance (CMR), and clinical markers. Methods: Eighty-one patients with nonapical HCM (51 men; mean age, 57 ± 14 years) who underwent CMR and echocardiography were prospectively evaluated. Cardiovascular events were defined as hospitalization for worsening HF, stroke, or cardiovascular death. Results: During the mean follow-up period of 41 ± 17 months, there were 17 cardiovascular events (5 deaths, 7 hospitalizations for worsening HF, and 5 strokes). Univariate analysis showed that older age, atrial fibrillation, elevated E/E′ ratio, increased left atrial (LA) volume index, presence of mitral regurgitation grade > 2, New York Heart Association class III or IV, and late gadolinium enhancement ≥ 6{\%} were associated with cardiovascular events. In multivariate Cox regression analysis, increased LA volume index was found to be an independent predictor of cardiovascular events (for each 5 mL/m 2 increase, hazard ratio, 1.28; 95{\%} confidence interval, 1.10-1.48; P < .01). Increased LA volume index was also revealed to be an independent predictor for cardiovascular events other than death (for each 5 mL/m 2 increase, hazard ratio, 1.44; 95{\%} confidence interval, 1.12-1.83; P < .01). Conclusion: LA volume index is independently associated with adverse outcomes in patients with HCM and provides additional prognostic information.",
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Left Atrial Volume Index : A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy. / Yang, Woo In; Shim, ChiYoung; Kim, Youngjin; Kim, Sung Ai; Rhee, Sang Jae; Choi, Eui Young; Choi, Donghoon; Jang, Yangsoo; Chung, Namsik; Cho, Seung Yun; Ha, Jong Won.

In: Journal of the American Society of Echocardiography, Vol. 22, No. 12, 01.12.2009, p. 1338-1343.

Research output: Contribution to journalArticle

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T1 - Left Atrial Volume Index

T2 - A Predictor of Adverse Outcome in Patients With Hypertrophic Cardiomyopathy

AU - Yang, Woo In

AU - Shim, ChiYoung

AU - Kim, Youngjin

AU - Kim, Sung Ai

AU - Rhee, Sang Jae

AU - Choi, Eui Young

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Chung, Namsik

AU - Cho, Seung Yun

AU - Ha, Jong Won

PY - 2009/12/1

Y1 - 2009/12/1

N2 - Background: Despite the relatively benign course for the majority of patients with hypertrophic cardiomyopathy (HCM), this disease may cause sudden cardiac death and progressive heart failure (HF). The aim of this study was to investigate useful parameters for predicting adverse outcomes of HCM, including echocardiographic parameters, cardiac magnetic resonance (CMR), and clinical markers. Methods: Eighty-one patients with nonapical HCM (51 men; mean age, 57 ± 14 years) who underwent CMR and echocardiography were prospectively evaluated. Cardiovascular events were defined as hospitalization for worsening HF, stroke, or cardiovascular death. Results: During the mean follow-up period of 41 ± 17 months, there were 17 cardiovascular events (5 deaths, 7 hospitalizations for worsening HF, and 5 strokes). Univariate analysis showed that older age, atrial fibrillation, elevated E/E′ ratio, increased left atrial (LA) volume index, presence of mitral regurgitation grade > 2, New York Heart Association class III or IV, and late gadolinium enhancement ≥ 6% were associated with cardiovascular events. In multivariate Cox regression analysis, increased LA volume index was found to be an independent predictor of cardiovascular events (for each 5 mL/m 2 increase, hazard ratio, 1.28; 95% confidence interval, 1.10-1.48; P < .01). Increased LA volume index was also revealed to be an independent predictor for cardiovascular events other than death (for each 5 mL/m 2 increase, hazard ratio, 1.44; 95% confidence interval, 1.12-1.83; P < .01). Conclusion: LA volume index is independently associated with adverse outcomes in patients with HCM and provides additional prognostic information.

AB - Background: Despite the relatively benign course for the majority of patients with hypertrophic cardiomyopathy (HCM), this disease may cause sudden cardiac death and progressive heart failure (HF). The aim of this study was to investigate useful parameters for predicting adverse outcomes of HCM, including echocardiographic parameters, cardiac magnetic resonance (CMR), and clinical markers. Methods: Eighty-one patients with nonapical HCM (51 men; mean age, 57 ± 14 years) who underwent CMR and echocardiography were prospectively evaluated. Cardiovascular events were defined as hospitalization for worsening HF, stroke, or cardiovascular death. Results: During the mean follow-up period of 41 ± 17 months, there were 17 cardiovascular events (5 deaths, 7 hospitalizations for worsening HF, and 5 strokes). Univariate analysis showed that older age, atrial fibrillation, elevated E/E′ ratio, increased left atrial (LA) volume index, presence of mitral regurgitation grade > 2, New York Heart Association class III or IV, and late gadolinium enhancement ≥ 6% were associated with cardiovascular events. In multivariate Cox regression analysis, increased LA volume index was found to be an independent predictor of cardiovascular events (for each 5 mL/m 2 increase, hazard ratio, 1.28; 95% confidence interval, 1.10-1.48; P < .01). Increased LA volume index was also revealed to be an independent predictor for cardiovascular events other than death (for each 5 mL/m 2 increase, hazard ratio, 1.44; 95% confidence interval, 1.12-1.83; P < .01). Conclusion: LA volume index is independently associated with adverse outcomes in patients with HCM and provides additional prognostic information.

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