Prognostic value of left atrial volume index in hemodialysis patients.

OBJECTIVE To evaluate the prognostic value of left atrial volume index (LAVi) in the clinical course of hemodialysis (HD) patients, compared with previously established echocardiographic and clinical parameters. METHODS Echocardiograms were obtained from 118 hemodialysis patients, who were then followed for 19 +/- 8 months. Study endpoint was a composite of all-cause mortality and nonfatal cardiovascular events. Cox multivariate analysis was used do assess the independent prognostic value of LAVi. RESULTS On univariate analysis, LAVi and other clinical and echocardiographic parameters were predictive of prognosis. Multivariate analyses showed that LAVi was an independent predictor of prognosis (hazard ratio 1.03 per ml/m(2), 95% confidence interval: 1.01 to 1.05, p=0.014), and added incremental information to the model containing traditional predictors of cardiovascular risk, such as left ventricular mass, ejection fraction, and clinical variables (p=0.02). CONCLUSION LAVi is an independent predictor of prognosis in HD patients, providing incremental information to traditional clinical and Doppler echocardiographic data.