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עמוד בית
Thu, 22.02.24

ORIGINAL ARTICLES

IMAJ | volume 25

Journal 7, July 2023
pages: 468-472

Implications of Indeterminate and Determined Etiologies Leading to Small Left Atria

1 Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel 2 Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel 3 Department of Cardiology, Tulane University, New Orleans, Louisiana, USA 4 Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA

Summary

Background:

Small left atria (LA) is associated with an increased risk of mortality.

Objectives:

To determine whether the attributed risk of mortality is influenced by the underlying etiologies leading to decreased volumes.

Methods:

We retrospectively evaluated patients with an available LA volume index (LAVI) as measured by echocardiography who came to our institution between 2011 and 2016. Individuals with small LA (LAVI < 16 ml/m2) were included and divided according to the etiology of the small LA (determined or indeterminate) and investigated according to the specific etiology.

Results:

The cohort consisted of 288 patients with a mean age of 56 ± 18 years. An etiology for small LA was determined in 84% (n=242). The 1-year mortality rate of the entire cohort was 20.5%. Patients with indeterminate etiology (n=46) demonstrated a lower mortality rate compared with determined etiologies (8.7% vs. 22.7%, P = 0.031). However, following propensity score adjustments for baseline characteristics, there was no significant difference between the groups (P = 0.149). The only specific etiology independently associated with 1-year mortality was the presence of space occupying lesions (odds ratio 3.26, 95% confidence interval 1.02–10.39, P = 0.045).

Conclusions

: Small LA serve as a marker for negative outcomes, and even in cases of undetected etiology, the prognosis remains poor. The presence of small LA should alert the physician to a high risk of mortality, regardless of the underlying disease.

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