1CHU Ibn Rochd, Casablanca, Morocco
To identify the echocardiographic variables associated with increased LA volume index (LAVI), and test the prognostic value of LAVI in AS.
We prospectively included 77 patients with AS in sinus rhythm at enrolment. Echocardiography was performed at baseline. Follow-up was 6-12 months. Patients were divided into two groups according to the cut-off for event prediction during follow-up (35mL/m2).
Compared with LAVI<35mL/m2, patients with LAVI≥35mL/m2 had a lower stroke volume, cardiac output and left ventricular (LV) ejection fraction, greater LV volumes and mass and higher filling pressures. By linear regression, LAVI was best correlated with E wave mitral velocity (r=0.46), E/A ratio (r=0.37), E/e’ ratio (r=0.25), systolic pulmonary artery pressure (r=0.38) and LV longitudinal strain . Multivariable analysis confirmed the independent association of LAVI with age (P<0.001), indexed aortic valve area (P=0.05), indexed LV mass (P<0.001), LV ejection fraction (P=0.007), LV end-diastolic volume (P=0.001), E/A ratio (P<0.001) and E/e’ ratio (P<0.001). LAVI≥35mL/m2 was independently predictive of the combined endpoint of cardiovascular death or hospitalization for heart failure
LA enlargement is correlated with AS severity, but also with variables reflecting LV systolic and diastolic dysfunction.