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Prognostic value of left atrial volume index in degenerative mitral stenosis

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

Prognostic value of left atrial volume index in degenerative mitral stenosis

Chew Nicholas WS
Bax Jeroen J
Poh Kian Keong
Stassen Jan
Marsan Nina Ajmone
Ngiam Jinghao Nicholas
Leow Ryan
van der Bijl Pieter
Kong William KF
Li Tony Yi-Wei
Sia Ching-Hui
Kornowski Ran
Delgado Victoria
Yedidya Idit
Butcher Steele C
Katso/Avaa
Yedidya2022_Article_PrognosticValueOfLeftAtrialVol.pdf (623.8Kb)
Lataukset: 

SPRINGER
doi:10.1007/s10554-022-02691-z
URI
https://link.springer.com/article/10.1007/s10554-022-02691-z
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Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2022091258658
Tiivistelmä

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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