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Right Atrial Volume Index in Chronic Systolic Heart Failure and Prognosis.
- Source :
- JACC: Cardiovascular Imaging; May2009, Vol. 2 Issue 5, p527-534, 8p
- Publication Year :
- 2009
-
Abstract
- Objectives: The aim of this study was to determine the relationship between right atrial volume index (RAVI) and right ventricular (RV) systolic and diastolic function, as well as long-term prognosis in patients with chronic systolic heart failure (HF). Background: RV dysfunction is associated with poor prognosis in patients with HF, although echocardiographic assessment of RV systolic and diastolic dysfunction is challenging. The ability to visualize the RA allows a quantitative, highly reproducible assessment of the RA volume that can be indexed to body surface area. Methods: The ADEPT (Assessment of Doppler Echocardiography for Prognosis and Therapy) trial enrolled 192 subjects with chronic systolic HF (left ventricular ejection fraction [LVEF] ≤35%). The RA volume was calculated by Simpson''s method using single-plane RA area and indexed to body surface area (RAVI). RV systolic function was graded as normal, mild, mild-moderate, moderate, moderately severe, or severe dysfunction. Results: In our study cohort, the mean RAVI was 28 ± 15 ml/m<superscript>2</superscript>, and increased with worsening RV systolic dysfunction, LVEF, and LV diastolic dysfunction (Spearman''s r = 0.61, r = 0.26, and r = 0.51, respectively; p < 0.001 for all). RAVI correlated modestly with echocardiographic estimates of RV diastolic dysfunction, including tricuspid early/late velocities ratio (Spearman''s r = 0.34, p < 0.0001), hepatic vein systolic/diastolic ratio (Spearman''s r = −0.26, p < 0.001) but not tricuspid early/tricuspid annular early velocities ratio (E/Ea) (Spearman''s r = 0.12, p = 0.11). Increasing tertiles of RAVI were predictive of death, transplant, and/or HF hospitalization (log-rank p = 0.0002) and remained an independent predictor of adverse clinical events after adjusting for age, B-type natriuretic peptide, LV ejection fraction, RV systolic dysfunction, and tricuspid E/Ea ratio (hazard ratio: 2.00, 95% confidence interval: 1.15 to 3.58, p = 0.013). Conclusions: In patients with chronic systolic HF, RAVI is a determinant of right-sided systolic dysfunction. This quantitative and reproducible echocardiographic marker provides independent risk prediction of long-term adverse clinical events. [Copyright &y& Elsevier]
- Subjects :
- HEART failure
HEART diseases
PROGNOSIS
RIGHT heart ventricle
Subjects
Details
- Language :
- English
- ISSN :
- 1936878X
- Volume :
- 2
- Issue :
- 5
- Database :
- Supplemental Index
- Journal :
- JACC: Cardiovascular Imaging
- Publication Type :
- Academic Journal
- Accession number :
- 39785471
- Full Text :
- https://doi.org/10.1016/j.jcmg.2009.01.012