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J Am Coll Cardiol, 2007; 50:1254-1262, doi:10.1016/j.jacc.2007.06.025 (Published online 9 September 2007).
© 2007 by the American College of Cardiology Foundation
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Role of Left Atrial Size in Risk Stratification and Prognosis of Patients Undergoing Stress Echocardiography

Sripal Bangalore, MD, MHA, Siu-Sun Yao, MD, FACC and Farooq A. Chaudhry, MD, FACC*

Department of Medicine, Division of Cardiology, St. Luke’s-Roosevelt Hospital and Columbia University, New York, New York.


Figure 1
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  		Figure 1 Relationship Between Hexiles of Indexed Left Atrial Size and Cardiovascular Events

The risk of cardiovascular events increased with increasing indexed left atrial size.

 

Figure 2
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  		Figure 2 Kaplan-Meier Survival Curve Showing Event-Free Survival As a Function of LA Size

The number of patients at risk for each follow-up period is given below the graph. Patients with a dilated left atrium (indexed) had worse prognosis compared to patients with a normal left atrial (LA) size.

 

Figure 3
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  		Figure 3 ROC Curve for Assessing the Predictive Value of Indexed and Unindexed LA Size for Future CV Events

The predictive value of indexed and unindexed left atrial (LA) size based on the area under the receiver-operating characteristic (ROC) curve was comparable. CV = cardiovascular.

 

Figure 4
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  		Figure 4 Kaplan-Meier Survival Curve Showing Event-Free Survival as a Function of LA Size and SE Results

The number of patients at risk for each follow up period is given below the graph. An abnormal left atrial (LA) size (indexed) was able to effectively further risk stratify both the normal (NL) and abnormal (Abn) stress echocardiography (SE) subgroups.

 

Figure 5
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  		Figure 5 Cardiovascular Event Rate as a Function of SE Results Across Quartile of Indexed LA Size

Stress echocardiography (SE) effectively risk stratified patients in each quartile of left atrial (LA) size (indexed). With increasing quartile group, the risk of cardiovascular events increased in both the abnormal and normal SE groups. The p values refer to the difference between the event rates in the normal versus abnormal groups for each quartile of the LA indexed size.

 

Figure 6
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  		Figure 6 Incremental Prognostic Value of Indexed LA Size Over Clinical, SECG, REcho, and SEcho Variables

Left atrial (LA) size (indexed) provided incremental prognostic value over clinical, stress electrocardiographic (SECG), rest echocardiographic (REecho), and stress echocardiographic (SEcho) variables for the prediction of future cardiovascular events.

 




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Copyright © 2007 by the American College of Cardiology Foundation.