Left Atrial Volume Determinants in Patients with Non-Ischemic Dilated Cardiomyopathy

Background: Left atrial volume (LAV) is a predictor of prognosis in patients with heart failure. Objective: We aimed to evaluate the determinants of LAV in patients with dilated cardiomyopathy (DCM). Methods: Ninety patients with DCM and left ventricular (LV) ejection fraction ≤ 0.50 were included. LAV was measured with real-time three-dimensional echocardiography (eco3D). The variables evaluated were heart rate, systolic blood pressure, LV end-diastolic volume and end-systolic volume and ejection fraction (eco3D), mitral inflow E wave, tissue Doppler e ´ wave, E/e ´ ratio, intraventricular dyssynchrony, 3D dyssynchrony index and mitral regurgitation vena contracta. Pearson´s coefficient was used to identify the correlation of the LAV with the assessed variables. A multiple linear regression model was developed that included LAV as the dependent variable and the variables correlated with it as the predictive variables. Results: Mean age was 52 ± 11 years-old, LV ejection fraction: 31.5 ± 8.0 % (16-50%) and LAV: 39.2±15.7 ml/m. The variables that correlated with the LAV were LV end-diastolic volume (r = 0.38; p < 0.01), LV end-systolic volume (r = 0.43; p < 0.001), LV ejection fraction (r =-0.36; p < 0.01), E wave (r = 0.50; p < 0.01), E/e ´ ratio (r = 0.51; p < 0.01) and mitral regurgitation (r = 0.53; p < 0.01). A multivariate analysis identified the E/e ´ ratio (p = 0.02) and mitral regurgitation (p = 0.02) as the only independent variables associated with LAV increase