Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm.

@article{citeulike:3019850, abstract = {BACKGROUND: The clinical value of real-time 3-dimensional echocardiography assessments of left atrial volume in patients with left ventricular dysfunction has not been determined. METHODS: Real-time 3-dimensional echocardiography and 2-dimensional Doppler echocardiography were performed on the same day in 108 patients with severe left ventricular dysfunction and in sinus rhythm. End-systolic left atrial volumes were measured using real-time 3-dimensional echocardiography images (LAV-3D) and end-systolic left atrial volumes were calculated by the biplane area-length formula using 2-dimensional echocardiography (LAV-2D). Patients were observed clinically over 10 +/- 7 months. RESULTS: LAV-2D showed excellent correlation with LAV-3D (r = 0.88, P < .001), but the former was significantly smaller than the latter (-12 +/- 21 mL, P < .001). During follow-up, 31 patients (29\%) showed clinical events, including 3 cardiac deaths and 28 hospitalizations as a result of heart failure. Patients with clinical events had larger initial LAV-3D (P < .05) and LAV-2D (P = .05), higher transmitral E velocity, higher E/E' ratio, more severe mitral and tricuspid regurgitation, and higher maximal velocity of tricuspid regurgitation than the 77 patients without events. LAV-3D (P < .001) and age (P < .05) were independent predictors of cardiac events by Cox proportional hazard model, whereas LAV-2D was negatively involved. Patients with initial LAV-3D less than 100 mL had a significantly higher 1-year event-free survival than those with LAV-3D greater than or equal to 100 mL (80 +/- 7 vs 48 +/- 10\%, P < .001). CONCLUSIONS: LAV-3D is a major predictor of clinical events in patients with severe left ventricular dysfunction and in sinus rhythm. The clinical value of LAV-3D seems to be superior to that of LAV-2D.}, address = {Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.}, author = {Suh, I. W. and Song, J. M. and Lee, E. Y. and Kang, S. H. and Kim, M. J. and Kim, J. J. and Kang, D. H. and Song, J. K. }, citeulike-article-id = {3019850}, doi = {http://dx.doi.org/10.1016/j.echo.2007.09.002}, issn = {1097-6795}, journal = {Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography}, keywords = {echo, pc, volume}, month = {May}, number = {5}, pages = {439--445}, posted-at = {2008-07-19 02:06:24}, priority = {2}, title = {Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm.}, url = {http://dx.doi.org/10.1016/j.echo.2007.09.002}, volume = {21}, year = {2008} }

TY - JOUR ID - citeulike:3019850 L3 - citeulike-article-id:3019850 TI - Left atrial volume measured by real-time 3-dimensional echocardiography predicts clinical outcomes in patients with severe left ventricular dysfunction and in sinus rhythm. JF - Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography VL - 21 IS - 5 SP - 439 EP - 445 AD - Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. SN - 1097-6795 N2 - BACKGROUND: The clinical value of real-time 3-dimensional echocardiography assessments of left atrial volume in patients with left ventricular dysfunction has not been determined. METHODS: Real-time 3-dimensional echocardiography and 2-dimensional Doppler echocardiography were performed on the same day in 108 patients with severe left ventricular dysfunction and in sinus rhythm. End-systolic left atrial volumes were measured using real-time 3-dimensional echocardiography images (LAV-3D) and end-systolic left atrial volumes were calculated by the biplane area-length formula using 2-dimensional echocardiography (LAV-2D). Patients were observed clinically over 10 +/- 7 months. RESULTS: LAV-2D showed excellent correlation with LAV-3D (r = 0.88, P < .001), but the former was significantly smaller than the latter (-12 +/- 21 mL, P < .001). During follow-up, 31 patients (29%) showed clinical events, including 3 cardiac deaths and 28 hospitalizations as a result of heart failure. Patients with clinical events had larger initial LAV-3D (P < .05) and LAV-2D (P = .05), higher transmitral E velocity, higher E/E' ratio, more severe mitral and tricuspid regurgitation, and higher maximal velocity of tricuspid regurgitation than the 77 patients without events. LAV-3D (P < .001) and age (P < .05) were independent predictors of cardiac events by Cox proportional hazard model, whereas LAV-2D was negatively involved. Patients with initial LAV-3D less than 100 mL had a significantly higher 1-year event-free survival than those with LAV-3D greater than or equal to 100 mL (80 +/- 7 vs 48 +/- 10%, P < .001). CONCLUSIONS: LAV-3D is a major predictor of clinical events in patients with severe left ventricular dysfunction and in sinus rhythm. The clinical value of LAV-3D seems to be superior to that of LAV-2D. KW - echo KW - pc KW - volume AU - Suh, IW AU - Song, JM AU - Lee, EY AU - Kang, SH AU - Kim, MJ AU - Kim, JJ AU - Kang, DH AU - Song, JK PY - 2008/05// UR - http://dx.doi.org/10.1016/j.echo.2007.09.002 ER -