Seitetsu L Lee1, Masao Daimon2, Tomoko Nakao3, Daniel E Singer4, Tomohiro Shinozaki5, Takayuki Kawata1, Koichi Kimura1, Megumi Hirokawa1, Tomoko S Kato6, Yoshiko Mizuno7, Masafumi Watanabe1, Yutaka Yatomi8, Tsutomu Yamazaki9, Issei Komuro1. 1. Department of Cardiovascular Medicine, the University of Tokyo, Tokyo, Japan. 2. Department of Cardiovascular Medicine, the University of Tokyo, Tokyo, Japan; Department of Clinical Laboratory, the University of Tokyo, Tokyo, Japan. Electronic address: daimon@muf.biglobe.ne.jp. 3. Department of Cardiovascular Medicine, the University of Tokyo, Tokyo, Japan; Department of Clinical Laboratory, the University of Tokyo, Tokyo, Japan. 4. Division of General Internal Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, USA. 5. Department of Biostatistics, the University of Tokyo, Tokyo, Japan. 6. Department of Clinical Laboratory, the University of Tokyo, Tokyo, Japan; Heart Center, Juntendo University School of Medicine, Tokyo, Japan. 7. Department of Cardiovascular Medicine, the University of Tokyo, Tokyo, Japan; Department of Clinical Epidemiology and Systems, the University of Tokyo, Tokyo, Japan. 8. Department of Clinical Laboratory, the University of Tokyo, Tokyo, Japan. 9. Clinical Research Support Center, the University of Tokyo, Tokyo, Japan.
Abstract
BACKGROUND: 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 lnLAV 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.
BACKGROUND: 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 lnLAV 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.
Authors: Simon Hellwig; Ulrike Grittner; Matthias Elgeti; Sebastian Wyschkon; Sebastian N Nagel; Jochen B Fiebach; Thomas Krause; Juliane Herm; Jan F Scheitz; Matthias Endres; Christian H Nolte; Karl Georg Haeusler; Thomas Elgeti Journal: ESC Heart Fail Date: 2020-07-15