Azannai Isis1

1CHU Ibn Rochd, Casablanca, Morocco

Background:
To identify the echocardiographic variables associated with increased LA volume index (LAVI), and test the prognostic value of LAVI in AS.

Method(s):
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).

Result(s):
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

Conclusion(s):
LA enlargement is correlated with AS severity, but also with variables reflecting LV systolic and diastolic dysfunction.