Left atrial volume is an independent predictor of exercise capacity in patients with isolated left ventricular diastolic dysfunction

Abstract Left atrial (LA) volume reflects left ventricular (LV) diastolic properties. The latter is an important determinant of exercise capacity in patients with normal LV systolic function. We hypothesized that LA volume predicts exercise capacity in patients with isolated LV diastolic dysfunction...

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Bibliographic Details
Published in:International journal of cardiology 2010-10, Vol.144 (3), p.425-427
Main Authors: Wong, Raymond Ching-Chiew, Yeo, Tiong Cheng
Format: Article
Language:English
Subjects:
Adult
Aged
Analysis of Variance
Biological and medical sciences
Cardiology. Vascular system
Cardiovascular
Diastole
Diastolic dysfunction
Exercise capacity
Exercise Test
Female
Heart
Heart Atria - diagnostic imaging
Heart Atria - physiopathology
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
Left atrial volume
Male
Medical sciences
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Retrospective Studies
Sensitivity and Specificity
Ultrasonography
Ventricular Dysfunction, Left - diagnostic imaging
Ventricular Dysfunction, Left - physiopathology
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Summary:Abstract Left atrial (LA) volume reflects left ventricular (LV) diastolic properties. The latter is an important determinant of exercise capacity in patients with normal LV systolic function. We hypothesized that LA volume predicts exercise capacity in patients with isolated LV diastolic dysfunction. Echocardiography and treadmill exercise testing were performed in 256 patients with normal LV systolic function (ejection fraction ≥ 50%). Diastolic dysfunction was defined using standard Doppler criteria. LA volume was measured using the ellipsoid method and indexed to the body surface area. 119 patients had LV diastolic dysfunction. They had higher indexed maximum LA volume (LA Volmax , p = 0.004) and lower exercise capacity ( p < 0.001). Univariate predictors of exercise capacity were age, mitral E / A , E wave deceleration time, ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity ( E / Ea), and indexed LA Volmax . On multivariate analysis, only age, mitral E / A and indexed LA Volmax were independent predictors of exercise capacity. Notably, the combination of LV diastolic dysfunction and enlarged LA Volmax predicted worse exercise intolerance. In conclusion, indexed LA volume is an independent and reliable predictor of exercise capacity in patients with isolated LV diastolic dysfunction.
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2009.03.060