Relação entre volume do átrio esquerdo e disfunção diastólica em 500 casos de uma população brasileira

• Autor(a) principal: Aouar, Lília Maria Mameri El [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Meyerfreud, Diana, Magalhães, Pedro, Rodrigues, Sérgio Lamêgo, Baldo, Marcelo Perim, Brasil, Yara, Aouar, Sumaya Mameri El, Aouar, Nabih Amin El, Mill, José Geraldo, Campos Filho, Orlando [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.5935/abc.20130109; http://repositorio.unifesp.br/handle/11600/7845
• topic: Ventricular Dysfunction; Stroke Volume; Atrial Function; Left; Brazil; Disfunção Ventricular; Volume Sistólico; Função Atrial Esquerda; Brasil

BACKGROUND: Left atrial volume index (LAVI) increase has been associated to left ventricle (LV) diastolic dysfunction (DD), a marker of cardiovascular events (atrial fibrillation, stroke, heart failure, death). OBJECTIVE: To evaluate the relationship between LAVI and diferente grades od DD in Brazilian patients submitted to echocardiogram, studying LAVI increase determinants in this sample. METHODS: We have selected 500 outpatients submitted to echocardiography, after excluding arrhythmia, valvar or congenital cardiopathy, permanent pacemaker or inadequate ecocardiographic window. LAVI was obtained according to Simpson's method. DD was classified according to current guidelines. The clinical and echocardiographic variables were submitted to linear regression multivariate analysis. RESULTS: Mean age was 52 ± 15 years old, 53% were male, 55% had arterial hypertension, 9% had coronary artery disease, 8% were diabetic, 24% were obese, 47% had LV hypertrophy. The mean ejection fraction of the left ventricle was 69.6 ± 7,2%. The prevalence of DD in this sample was 33.8% (grade I: 66%, grade II: 29% e grade III: 5%). LAVI increased progressively according to DD grade: 21 ± 4 mL/m² (absent), 26 ± 7 mL/m² (grade I), 33 ± 5 mL/m² (grade II), 50 ± 5 mL/m2 (grade III) (p < 0,001). In this sample, LAVI increase independent predictors were age, left ventricular mass, relative wall thickness, LV ejection fraction and E/e' ratio. CONCLUSION: DD contributes to left atrial remodeling. LAVI increases as an expression of DD severity and is independently associated to age, left ventricle hypertrophy, systolic dysfunction and increased LV filling pressures.