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Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction.

Publication ,  Journal Article
Ivanov, A; Mohamed, A; Asfour, A; Ho, J; Khan, SA; Chen, O; Klem, I; Ramasubbu, K; Brener, SJ; Heitner, JF
Published in: PLoS One
2017

BACKGROUND: Right Atrial Volume Index (RAVI) measured by echocardiography is an independent predictor of morbidity in patients with heart failure (HF) with reduced ejection fraction (HFrEF). The aim of this study is to evaluate the predictive value of RAVI assessed by cardiac magnetic resonance (CMR) for all-cause mortality in patients with HFrEF and to assess its additive contribution to the validated Meta-Analysis Global Group in Chronic heart failure (MAGGIC) score. METHODS AND RESULTS: We identified 243 patients (mean age 60 ± 15; 33% women) with left ventricular ejection fraction (LVEF) ≤ 35% measured by CMR. Right atrial volume was calculated based on area in two- and four -chamber views using validated equation, followed by indexing to body surface area. MAGGIC score was calculated using online calculator. During mean period of 2.4 years 33 patients (14%) died. The mean RAVI was 53 ± 26 ml/m2; significantly larger in patients with than without an event (78.7±29 ml/m2 vs. 48±22 ml/m2, p<0.001). RAVI (per ml/m2) was an independent predictor of mortality [HR = 1.03 (1.01-1.04), p = 0.001]. RAVI has a greater discriminatory ability than LVEF, left atrial volume index and right ventricular ejection fraction (RVEF) (C-statistic 0.8±0.08 vs 0.55±0.1, 0.62±0.11, 0.68±0.11, respectively, all p<0.02). The addition of RAVI to the MAGGIC score significantly improves risk stratification (integrated discrimination improvement 13%, and category-free net reclassification improvement 73%, both p<0.001). CONCLUSION: RAVI by CMR is an independent predictor of mortality in patients with HFrEF. The addition of RAVI to MAGGIC score improves mortality risk stratification.

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Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

4

Start / End Page

e0173245

Location

United States

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Predictive Value of Tests
  • New York City
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Heart Failure
  • Heart Atria
 

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Ivanov, A., Mohamed, A., Asfour, A., Ho, J., Khan, S. A., Chen, O., … Heitner, J. F. (2017). Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction. PLoS One, 12(4), e0173245. https://doi.org/10.1371/journal.pone.0173245
Ivanov, Alexander, Ambreen Mohamed, Ahmed Asfour, Jean Ho, Saadat A. Khan, Onn Chen, Igor Klem, Kumudha Ramasubbu, Sorin J. Brener, and John F. Heitner. “Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction.PLoS One 12, no. 4 (2017): e0173245. https://doi.org/10.1371/journal.pone.0173245.
Ivanov A, Mohamed A, Asfour A, Ho J, Khan SA, Chen O, et al. Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction. PLoS One. 2017;12(4):e0173245.
Ivanov, Alexander, et al. “Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction.PLoS One, vol. 12, no. 4, 2017, p. e0173245. Pubmed, doi:10.1371/journal.pone.0173245.
Ivanov A, Mohamed A, Asfour A, Ho J, Khan SA, Chen O, Klem I, Ramasubbu K, Brener SJ, Heitner JF. Right atrial volume by cardiovascular magnetic resonance predicts mortality in patients with heart failure with reduced ejection fraction. PLoS One. 2017;12(4):e0173245.

Published In

PLoS One

DOI

EISSN

1932-6203

Publication Date

2017

Volume

12

Issue

4

Start / End Page

e0173245

Location

United States

Related Subject Headings

  • Stroke Volume
  • Risk Factors
  • Predictive Value of Tests
  • New York City
  • Middle Aged
  • Male
  • Magnetic Resonance Imaging
  • Humans
  • Heart Failure
  • Heart Atria