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Associates and Prognosis of Giant Left Atrium; Single Center Experience

Authors
 Hyoeun Kim  ;  Young-Ah Park  ;  Sung Min Choi  ;  Hyemoon Chung  ;  Jong-Youn Kim  ;  Pil-Ki Min  ;  Young Won Yoon  ;  Byoung Kwon Lee  ;  Bum-Kee Hong  ;  Se-Joong Rim  ;  Hyuck Moon Kwon  ;  Eui-Young Choi 
Citation
 Journal of Cardiovascular Ultrasound, Vol.25(3) : 84-90, 2017 
Journal Title
 Journal of Cardiovascular Ultrasound 
ISSN
 1975-4612 
Issue Date
2017
Keywords
Cardiovascular events ; Echocardiography ; Left atrium ; Remodeling
Abstract
Background: Left atrial (LA) remodeling develops as a result of longstanding pressure overload. However, determinants and clinical outcome of excessive remodeling, so called giant left atrium (GLA), are not clear. Methods: Clinical characteristics of patients with GLA (antero-posterior diameter higher than 65 mm), including echo-Doppler parameters, and follow-up clinical outcomes from a tertiary referral hospital were investigated. Results: Among 68519 consecutive primary patients who underwent echocardiography over a period of 10 years, data from 163 GLA cases (0.24%) were analyzed. Main causes were significant rheumatic mitral stenosis (n = 58, 36%); other causes comprised significant rheumatic mitral regurgitation (MR; n = 10, 6%), mitral valve (MV) prolapse or congenital mitral valvular disease (MVD) (n = 20, 12%), and functional MR (n = 25, 15%). However, mild rheumatic MV disease (n = 4, 3%) or left ventricular (LV) systolic or diastolic dysfunction without significant MR (n = 46, 28%) were also causes of GLA. During median follow-up of 22 months, 42 cases (26%) underwent composite events. MV surgery was related to lower rate of composite events. In multivariate analysis, MV surgery, elevated pulmonary arterial systolic pressure, and increased LA volume index were independent predictors of future events (p < 0.05) regardless of underlying diseases or history of MV surgery. Conclusion: Although rheumatic MVD with atrial fibrillation is the main contributor to GLA, longstanding atrial fibrillation with LV dysfunction but without MVD also could be related to GLA. Even in GLA state, accurate measurement of LA volume is crucial for risk stratification for future events, regardless of underlying disease.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161008
DOI
10.4250/jcu.2017.25.3.84
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
Yonsei Authors
권혁문(Kwon, Hyuck Moon) ; 김종윤(Kim, Jong Youn) ; 김효은(Kim, Hyo Eun) ; 민필기(Min, Pil Ki) ; 윤영원(Yoon, Young Won) ; 이병권(Lee, Byoung Kwon) ; 임세중(Rim, Se Joong) ; 최성민(Choi, Sung Min) ; 최의영(Choi, Eui Young) ; 홍범기(Hong, Bum Kee)
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