Indexed dimension of left atrium as potential prognostic factor in heart failure with preserved ejection fraction (HFpEF)
M L LeszczykAbstract
Background
The prevalence of HFpEF is increasing across all populations with high rates of hospitalization and mortality. We are still looking for specific indicators that may have prognostic significance beyond usual biomarkers.
Purpose
Assessment of body surface area-indexed echocardiographic left atrial anteroposterior dimension (LA/BSA) as a simple promising prognostic factor in HFpEF exacerbations.
Methods
242 patients with HFpEF exacerbation were included in study. This population was divided into 2 subgroups: patients with normal LA/BSA value (below 23 mm/m2) and those with elevated index. During analyses, the independent samples T-test and the Chi-square test of independence were used.
Results
The tendency toward higher in-hospital mortality was observed in patients with abnormal LA/BSA value compared to the others (6,5 vs. 4,6 %), but without statistical significance (p > 0,05). Moreover those with elevated LA/BSA index had significantly higher echocardiographic E/e’ parameter (14,1 vs. 10,2; p = 0,007), which reflects elevated left ventricular filling pressure and is prognostic. Higher concentrations of natriuretic peptides were also observed in patients with higher LA/BSA: BNP (389 vs. 331 pg/ml) and NT-proBNP (6510 vs. 4641 pg/ml), although without statistical significance. Patients with elevated LA/BSA were significantly older (81,9 vs. 76,3 years; p < 0,001) and more often had coronary arterial disease (67,7 vs. 44,8 %; p < 0,01) as well as atrial fibrillation at admission (67,7 vs. 47,1 %; p < 0,05).
Conclusion
Simple left atrial size index (LA/BSA) could become valuable prognostic parameter in HFpEF after conducting further larger studies.