Heart failure & cardiomyopathiesCohort study
Left Atrial Volumetric Enlargement in Heart Failure With Reduced Ejection Fraction
- Retrospective cohort study
- single-centre
Authors' conclusion
LAVI is an independent predictor of mortality in heart failure stage B or C, with excess risk starting at 40 mL/m2. The prognostic impact of LAVI persisted with a graded relationship in all FMR severity grades, emphasizing its role in risk stratification.
Study context
- Population
- Patients with HF stage B or C and a first diagnosis of reduced LVEF (<50%) at Mayo Clinic
- Participants
- 13,954 patients
- Exposure
- LA volume index (LAVI) and long-term mortality, by functional mitral regurgitation (FMR) severity
- Outcome
- Long-term mortality by left atrial (LA) volume index (LAVI)
Main finding
Mortality
Hazard ratio
1.13 per 10 mL/m²
P < 0.0001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Mean LAVI by FMR severity
LAVI–mortality relationship by FMR grade (subgroup)
- Excess-mortality threshold about 40 mL/m² in no-mild FMR
- Excess-mortality threshold about 60 mL/m² in severe FMR
- Slope of relationship unaltered at each FMR grade
- P for interaction = 0.35
Interactions of LAVI with LVEF, AF and pulmonary hypertension
- Significant interactions between LAVI, LVEF, AF and pulmonary hypertension
Original publication
Left Atrial Volumetric Enlargement in Heart Failure With Reduced Ejection Fraction. JACC Heart Fail. Published 11 February 2026. doi:10.1016/j.jchf.2026.102946
Summarised from the published abstract; every number is checked against it