Usefulness of right atrial volume index in predicting outcome in chronic systolic heart failure

Abstract Background Right ventricular (RV) dysfunction is associated with poor prognosis in patients with heart failure (HF). Echocardiographic assessment of RV systolic function is challenging. The ability to visualize the right atrium (RA) allows a quantitative, highly reproducible assessment of RA volume. Objective The aim is to study the relationship between the right atrial volume index (RAVI) and prognosis in patients with chronic systolic HF. Methods 120 patients with chronic systolic HF and left ventricular ejection fraction (LVEF) tri ) using tissue Doppler imaging at the tricuspid annulus. The primary endpoint was death, urgent transplantation, or acute HF episode requiring hospital admission during a follow-up of 1year. Results Follow up was complete for 117 of 120 patients. Fifty-two patients reached the primary endpoint. The mean RAVI was higher in patients with adverse events (45.5±15ml/m 2 versus 25.2±11ml/m 2 , p tri (Spearman's r =−0.46, r =−0.45, r =−0.59, p 2 (area under the curve was 0.89%, 95% confidence interval: 0.82–0.95) with a sensitivity of 92%, and a specificity of 75%. NYHA>2 (OR=2.1, p p Conclusion In patients with chronic systolic HF, RAVI is an independent predictor of adverse outcome with a threshold value of 29ml/m 2 .