Left atrial volume as a predictor of heart function.

Objectives: This study was designed to identify an association between left atrial volume and systolic and diastolic functions of the left ventricle.

Background: Several studies have shown a relationship between the left atrial volume and different cardiovascular risk factors.

Methods: Transthoracic echocardiographic results of 268 patients (136 women and 132 men, mean age 60.2+/-17.3 years) were studied retrospectively. Key echocardiographic variables of systolic and diastolic function were related to the left atrial volume and its indexed value.

Results: The mean indexed left atrial volume in a subgroup of patients with normal echocardiography, was 25.3+/-6.7 ml/m2. Left atrial volume significantly (p<0.0001) increased in deteriorating diastolic function (impaired relaxation, pseudonormalized pattern, and restrictive physiology): 33.6+/-11.6, 48.7+/-21.8 and 84.5+/-60.5 ml/m2, respectively. There were also significant (p=0.0001) differences in cases with normal systolic function (EF>50 %) and systolic dysfunction (EF<50%): 37.9+/-24.1 vs 54.9+/-34.7 ml/m2. There were no significant differences in the left atrial volumes (33.1+/-10.9 ml/m2 and 38.3+/-15.4 ml/m2, p=0.13) in patients with normal systolic function and impaired relaxation compared to patients with systolic dysfunction. However, in both cases these values were different from those with normal echocardiography (p<0.0001). In multiple regression analysis the best predictor of enlarged left atrial volume was the left ventricular mass.

Conclusion: We found a strong association between left atrial volume and left ventricular systolic and diastolic dysfunction. The strongest association appeared between increasing left atrial volume and left ventricular mass (Tab. 2, Fig. 4, Ref. 26). Full Text (Free, PDF) www.bmj.sk.