Factors influencing left atrial volume in a population with preserved ejection fraction: Left ventricular diastolic dysfunction or clinical factors?

详细信息    查看全文

• 作者：Seitetsu L. Lee ; MD ; PhD^a ; Masao Daimon ; MD ; PhD ; FJCC ; FACC^a ; ^b ; ^{daimon@muf.biglobe.ne.jp" class="auth_mail" title="E-mail the corresponding author} ; Tomoko Nakao ; MD ; PhD^a ; ^b ; Daniel E. Singer ; MD^c ; Tomohiro Shinozaki ; MPH^d ; Takayuki Kawata ; MD ; PhD^a ; Koichi Kimura ; MD ; PhD^a ; Megumi Hirokawa ; MD^a ; Tomoko S. Kato ; MD ; PhD^b ; ^e ; Yoshiko Mizuno ; MD ; PhD^a ; ^f ; Masafumi Watanabe ; MD ; PhD ; FJCC^a ; Yutaka Yatomi ; MD ; PhD^b ; Tsutomu Yamazaki ; MD ; PhD ; FJCC^g ; Issei Komuro ; MD ; PhD ; FJCC^a
• 关键词：Left atrium ; Echocardiography ; Remodeling ; Obesity ; Risk factors
• 刊名：Journal of Cardiology
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：68
• 期：4
• 页码：275-281
• 全文大小：647 K

文摘

Increased left atrial volume (LAV) predicts a higher incidence of cardiovascular events and is widely recognized as a major surrogate marker of left ventricular (LV) diastolic dysfunction (DD). Although the pathophysiology of LA enlargement is probably multifactorial, few studies have examined comprehensively the clinical factors that lead to LA enlargement in the absence of valvular disease or LV systolic dysfunction. Therefore, we investigated associations between LAV and several clinical and echocardiographic parameters including DD.

Methods

We enrolled 557 subjects without significant valve disease or LV systolic dysfunction from the health check-up clinic retrospectively. We performed univariable and multivariable linear regression using ln LAV index as the dependent variable and the following independent variables: gender, age, smoking status, drinking habit, hypertension, diabetes, body mass index (BMI), LV ejection fraction, DD, LV mass index, hemoglobin, serum creatinine, serum total cholesterol, serum uric acid, serum sodium, and serum iron.

Results

In multivariable analysis, LAV index was independently associated with BMI, lower hemoglobin, and moderate and severe DD compared with normal diastolic function (p < 0.001), but not with mild DD (p = 0.70).

Conclusions

LA enlargement was independently associated with moderate and severe DD, but not with mild DD. Furthermore, obesity and lower hemoglobin were associated with LAV independently of DD.