The present study attempted to determine the accuracy of left atrial volume (LAVi) by transthoracic echocardiography in the diagnosis of diastolic heart failure (DHF) in patients presenting with chronic, isolated dyspnea. We included 28 consecutive patients with a left ventricular ejection fraction >50% without prior history of heart failure. DHF was authenticated in 20 patients by invasive left ventricular end-diastolic pressure >16 mmHg. By logistic regression analysis, LAVi was predictive of DHF (p=0.015). LAVi>38 ml/m(2) was a useful predictor of DHF (area under the ROC curve of 0.84 [0.65-0.95], p<0.001, sensitivity 60%, specificity 100%). The standard cut-off value of 34 ml/m(2) was 70% sensitive and 88% specific.
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