PMID- 22322084
OWN - NLM
STAT- MEDLINE
DCOM- 20120325
LR  - 20231105
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 59
IP  - 7
DP  - 2012 Feb 14
TI  - Left atrial function predicts heart failure hospitalization in subjects with 
      preserved ejection fraction and coronary heart disease: longitudinal data from 
      the Heart and Soul Study.
PG  - 673-80
LID - 10.1016/j.jacc.2011.11.012 [doi]
AB  - OBJECTIVES: This study sought to determine whether left atrial (LA) dysfunction 
      predicts heart failure (HF) hospitalization in subjects with preserved baseline 
      ejection fraction (EF). BACKGROUND: Among patients with preserved EF, factors 
      leading to HF are not fully understood. Cross-sectional studies have demonstrated 
      LA dysfunction at the time of HF, but longitudinal data on antecedent atrial 
      function are lacking. METHODS: We performed resting transthoracic 
      echocardiography in 855 subjects with coronary heart disease and EF >/=50%. Left 
      atrial functional index (LAFI) was calculated as ([LA emptying fraction x left 
      ventricular outflow tract-velocity time integral] / [indexed LA end-systolic 
      volume]), where LA emptying fraction was defined as (LA end-systolic volume--LA 
      end-diastolic volume) / LA end-systolic volume. We used Cox models to evaluate 
      the association between LAFI and HF hospitalization. RESULTS: Over a median 
      follow-up of 7.9 years, 106 participants (12.4%) were hospitalized for HF. Rates 
      of HF hospitalization were inversely proportional to quartile (Q) of LAFI: Q1, 47 
      per 1,000 person-years; Q2, 18.3; Q3, 9.6; and Q4, 5.3 (p < 0.001). Each standard 
      deviation decrease in LAFI was associated with a 2.6-fold increased hazard of 
      adverse cardiovascular outcomes (unadjusted hazard ratio: 2.6, 95% confidence 
      interval: 2.1 to 3.3, p < 0.001), and the association persisted even after 
      adjustment for clinical risk factors, N-terminal pro-B-type natriuretic peptide, 
      and a wide range of echocardiographic parameters (adjusted hazard ratio: 1.5, 95% 
      confidence interval: 1.0 to 2.1, p = 0.05). CONCLUSIONS: Left atrial dysfunction 
      independently predicts HF hospitalization in subjects with coronary heart disease 
      and preserved baseline EF. The LAFI may be useful for HF risk stratification, and 
      LA dysfunction may be a potential therapeutic target.
CI  - Copyright (c) 2012 American College of Cardiology Foundation. Published by Elsevier 
      Inc. All rights reserved.
FAU - Welles, Christine C
AU  - Welles CC
AD  - Department of Medicine, University of California, San Francisco, California; 
      Veterans Affairs Medical Center, San Francisco, California, USA.
FAU - Ku, Ivy A
AU  - Ku IA
FAU - Kwan, Damon M
AU  - Kwan DM
FAU - Whooley, Mary A
AU  - Whooley MA
FAU - Schiller, Nelson B
AU  - Schiller NB
FAU - Turakhia, Mintu P
AU  - Turakhia MP
LA  - eng
GR  - R01 HL079235/HL/NHLBI NIH HHS/United States
GR  - R01 HL079235-05/HL/NHLBI NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Function, Left/*physiology
MH  - Cohort Studies
MH  - Coronary Disease/epidemiology/*physiopathology/psychology
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/diagnosis/epidemiology/*physiopathology/psychology
MH  - *Hospitalization/trends
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Psychophysiology
MH  - Stroke Volume/*physiology
PMC - PMC3282121
MID - NIHMS351810
EDAT- 2012/02/11 06:00
MHDA- 2012/03/27 06:00
PMCR- 2013/02/14
CRDT- 2012/02/11 06:00
PHST- 2011/08/24 00:00 [received]
PHST- 2011/11/09 00:00 [revised]
PHST- 2011/11/15 00:00 [accepted]
PHST- 2012/02/11 06:00 [entrez]
PHST- 2012/02/11 06:00 [pubmed]
PHST- 2012/03/27 06:00 [medline]
PHST- 2013/02/14 00:00 [pmc-release]
AID - S0735-1097(11)05025-X [pii]
AID - 10.1016/j.jacc.2011.11.012 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2012 Feb 14;59(7):673-80. doi: 10.1016/j.jacc.2011.11.012.