Independent relationship of left atrial size and mortality in patients with heart failure: An individual patient meta-analysis of longitudinal data (MeRGE Heart Failure)

Andrea Rossi, Pier Luigi Temporelli, Miguel Quintana, Frank L. Dini, Stefano Ghio, Graham S. Hillis, Allan L. Klein, Nina Ajmone Marsan, David L. Prior, Cheuk Man Yu, Katrina K. Poppe, Robert N. Doughty, Gillian A. Whalley

Research output: Contribution to journalArticle

Abstract

Aims Left atrial (LA) size is considered a marker of poor prognosis in heart failure (HF) patients. Prior studies have recruited relatively few subjects limiting their power to adequately analyse the interaction between LA size, left ventricular (LV) systolic and diastolic function, and prognosis.Method and resultsThe MeRGE collaboration combines prospective data from 18 studies in HF patients. In this analysis of data from 1157 patients, the primary endpoint was death or hospitalization for worsening HF. In multivariate analysis (Cox proportion hazard model), LA area was associated with prognosis (HR 1.03 per cm2, 95% CI 1.02, 1.05; P <0.0001) independently of age, NYHA class, LV ejection fraction, and restrictive filling pattern (RFP). When LA area was used as a categorical variable, the HR associated with larger LA area (above median) was 1.4 (95% CI 1.13, 1.74) and when LA area index was used, the HR was 2.36 (95% CI 1.80, 3.08). When the patients with and without RFP were divided on the basis of either LA area or LA area index, significantly higher event rates were observed in those with larger LA area.Conclusion Left atrial area is a powerful predictor of outcome among HF patients with predominantly impaired systolic function, and is independent of, and provides additional prognostic information beyond LV systolic and diastolic function.

Original languageEnglish
Pages (from-to)929-936
Number of pages8
JournalEuropean Journal of Heart Failure
Volume11
Issue number10
DOIs
Publication statusPublished - Oct 2009

Keywords

  • Diastolic function
  • Heart failure
  • Left atrium
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Independent relationship of left atrial size and mortality in patients with heart failure: An individual patient meta-analysis of longitudinal data (MeRGE Heart Failure)'. Together they form a unique fingerprint.

  • Cite this

    Rossi, A., Temporelli, P. L., Quintana, M., Dini, F. L., Ghio, S., Hillis, G. S., Klein, A. L., Ajmone Marsan, N., Prior, D. L., Yu, C. M., Poppe, K. K., Doughty, R. N., & Whalley, G. A. (2009). Independent relationship of left atrial size and mortality in patients with heart failure: An individual patient meta-analysis of longitudinal data (MeRGE Heart Failure). European Journal of Heart Failure, 11(10), 929-936. https://doi.org/10.1093/eurjhf/hfp112