The Relationship between Left Atrial Volume and Diastolic Dysfunction in 500 Bangladeshi Patients

Background: An increase in the left atrial volume index (LAVI) has been linked to left ventricular (LV) diastolic dysfunction (DD), a risk factor for cardiovascular events. Objective: In this study our main goal is to evaluate the relationship between Left Atrial Volume and Diastolic Dysfunction in 500 Bangladeshi Patients. Method: This cross sectional study was carried out at tertiary hospital from January 2021 to January 2022 among 500 Bangladeshi patients in whom a transthoracic echo was indicated were studied at cardiology department. The eligible patients were adults aged 20 to 86 years, who presented sinus rhythm and had no history of atrial or ventricular arrhythmia, pacemaker use, valvular disease (other than mild) or congenital cardiopathy. Forty five individuals were excluded since their exams were not adequate for analyzing mitral diastolic flow (n = 35) or LAVI (n = 10). The 500 remaining patients comprised the final sample for this study. Results: Mean age and male percentage were higher in the DD groups as compared to the normal function group left ventricular mass were higher in the DD groups as compared to the normal function group. The ejection fraction was markedly reduced only in the grade III DD group (ventricular filling restriction pattern).LAVI and dimensions progressively increased with DD grade increase: 21 ± 4.2 mL/m2, 26.1 ± 7.5mL/m2 (grade I), 33.4 ± 4.6mL/m2 (grade II), 50.4 ± 2.8mL/m2 (grade III) (p < 0.001). Plus, as expected, there was a relative decrease of the E- wave and E/A ratio, and an increase of the mitral deceleration time in the grade I DD groups (altered relaxation) in comparison to the group with normal diastolic function; the opposite was observed in the group with grade III DD (restrictive pattern). The e' wave was significantly smaller in all DD grades, in comparison to the group with preserved diastolic function. Progressive increase of the E/e' ratio was observed with worsening DD. There was a significant and ......