Prognostic value of left atrial volume index in hemodialysis patients

Objective: To evaluate the prognostic value of left atrial volume index (LAW) in the clinical course of hemodialysis (HO) 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 LAW. Results: On univariate analysis, LAW 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 = 0.074), 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.