Predictive Value of Left Atrial Size in Patients Who Underwent Dobutamine Stress Echocardiography for Suspected Coronary Artery Disease

Purpose: Resting left atrial volume index (LAVI) has been reported as a predictor of cardiovascular events. We therefore sought to determine the predictive value of resting LAVI in patients who underwent dobutamine stress echocar-diography (DSE) for suspected ischemic heart disease (IHD) in a tertiary care hospital, south west of Saudi Arabia. Methods: Ninety consecutive patients who underwent outpatient DSE for suspected IHD between September 1, 2009, and December 31, 2010 were studied. All patients were subjected to: Meticulous history taking, complete physical examination, 12 lead resting ECG and echocardiogram with measurement of resting LAVI (value of !928ml/m2 was con-sidered normal). Results: Abnormal DSE was detected in 36 (40%) patients. Among those 33 (91.7%) patients had abnormal resting LAVI and 3 (8.3%) had normal resting LAVI. The resting LAVI had a sensitivity value of 91.7% (95% CI: 76.4%-97.8%) and a negative predictive value of 88.8% (95% CI: 69.7%- 97.1%). No significant difference was found between patients with normal or abnormal resting LAVI regarding age, gender, dyslipidemia, smoking, diabetes, hypertension, or ejection fraction. Conclusion: A normal resting LAVI was a strong predictor of a normal DSE in our setting in south west, Saudi Arabia. It is a readily available and a simple procedure that can be utilized in screening low risk IHD patients.