Left atrial volume index is superior to left atrial diameter index in relation to coronary heart disease in hypertension patients with preserved left ventricular ejection fraction

ABSTRACT

Objective: Research hypothesis is that left atrial (LA) volume index is superior to LA diameter index for coronary heart disease and LA volume index is important to refine risk stratification.

Methods: We retrospectively enrolled 222 asymptomatic non-ischemic patients with hypertension who had stored digital images in 2012. Patients were followed up for coronary heart disease over a median of 3.2 years. The Area under receiver operating characteristic curve for LA parameters with coronary heart disease was evaluated. Cox regression was used to assess the association between left atrial parameters and coronary heart disease.

Results: The mean age of patients was 62 years, 45% were men, and mean left atrial diameter, mean left atrial volume, mean LA diameter index, mean LA volume index was 32 mm, 43 ml, 21 mm/m2, 27 ml/m2, respectively. After 3.2 years follow up, 10 patients experienced coronary heart disease. Compared with patients without coronary heart disease, LA diameter index and LA volume index increased in coronary heart disease group (P < 0.05). Multivariate cox regression analysis showed, adjusted for age, sex, smoking, cholesterol, fasting plasma glucose, diabetes, systolic blood pressure, left ventricular mass index, and E/e’ ratio, a unit rise in LA volume index was associated with a 15% increase in the risk of coronary heart disease. (HR:1.155; 95% CI 1.002–1.332). Compared with LA diameter index, the area under receiver operating characteristic curve values for predicting coronary heart disease were higher for LA volume index (0.797).

Conclusions: Our study showed that LA volume index was superior to LA diameter index. LA volume index had independent prognostic implications in terms of coronary heart disease prediction in hypertension patients with preserved left ventricular ejection fraction.

KEYWORDS:

• Left atrial diameter
• left atrial volume
• coronary heart disease
• hypertension
• clinical outcome

Acknowledgments

The authors thank all the participants for their efforts and contributions.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by the Natural Science Foundation of Guangdong Province [No. 2015A030313660], the Science and Technology Program of Guangzhou [No. 201604020143, No. 201604020018, No. 201510010254, No. 201803030012], the Medical Science and Technology Research Fund of Guangdong Province [No. B2018023], the National Key Research and Development Program of China [No. 2017FYC1307603, No. 2016YFC1301305] and the Science and Technology Program of Guangdong Province [No. 2014B020212008].