Valvular & structural heart diseaseCohort study
Longitudinal Assessment of Left Atrial Remodeling in Patients With Chronic Severe Aortic Regurgitation
- Retrospective cohort study
- serial echocardiography
Authors' conclusion
Unlike LV remodeling, LA remodeling demonstrates a similar rate of progression between categories of sex and age among patients with AR. In addition, LA parameters provide incremental prognostic value over LV parameters.
Study context
- Population
- Patients with moderate to severe or severe aortic regurgitation (AR) with serial echocardiography (2010–2016)25.7% women
- Participants
- 525 patients
- Exposure
- Left atrial (LA) vs left ventricular (LV) parameters to inform timing of AR intervention
- Outcome
- Longitudinal trends in LAVI and LA reservoir strain by sex and age; incremental prediction of adverse events over LV parameters
Main finding
As reported in the abstract
LA remodeling over time · median follow-up 2.0 years (Q1-Q3: 1.0-3.6 years)
- Increase in left atrial volume index (LAVI)
- 1.0 mL/m² per year [95% CI: 0.76-1.2 mL/m² per year]
- Decrease in LAr
- −1.3% per year [95% CI: −1.6% to −0.92%]
- No significant interaction by sex or age category
- P for interaction ≥ 0.17
- Optimal discriminatory threshold LAVI
- 37 mL/m²
- Optimal discriminatory threshold LAr
- 35%
Observational data: associations, not effects.
Further findings
Survival with surgery, LAVI ≥37 mL/m² (subgroup)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Surgery | 0.33 (0.15–0.72) | P = 0.006 | |
| 0.10.31310Hazard ratio (log scale) |
Survival with surgery, LAVI <37 mL/m² (subgroup)
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Surgery · not statistically significant | 0.46 (0.18–1.17) | P = 0.09 | |
| 0.20.5125Hazard ratio (log scale) |
Survival with surgery by LAr (subgroup)
- Surgery associated with survival for LAr ≤35% but not LAr >35%
Original publication
Longitudinal Assessment of Left Atrial Remodeling in Patients With Chronic Severe Aortic Regurgitation. JACC Cardiovasc Imaging. Published 12 June 2024. doi:10.1016/j.jcmg.2024.04.007
Summarised from the published abstract; every number is checked against it