Left Atrial Volume in Chronic Obstructive Pulmonary Disease

Purpose: The aim of the study was to evaluate left atrial (LA) volume in smokers according to the severity of emphysema, with the objective of providing indirect evidence of reduced pulmonary venous return due to capillary destruction. Materials and Methods: A total of 121 smokers underwent a high-pitch and high-temporal resolution computed tomography (CT) angiographic examination, enabling quantification of emphysema, total lung volume, and LA volume measurements normalized to body surface area. Results: The CT phenotypes were as follows: emphysema predominant (group 1; n = 57); airway predominant (group 2; n = 30); a mixed pattern of emphysema and airway disease (group 3; n = 15); and absence of bronchopulmonary CT abnormalities (group 4; n = 19). A negative correlation was found between the indexed LA volume and the percentage of emphysema: (a) in the overall study group (P = 0.032; r = -0.19); (b) in group 1 (P = 0.0163; r = -0.32); and (c) in groups 1 and 3 when analyzed together (P = 0.0492; r = -0.23). A negative correlation was found between the indexed LA volume and the total lung volume in the overall study group (P = 0.039; r = -0.19) and in group 1 (P = 0.048; r = -0.26), whereas no correlations were found in group 2 (P = 0.44; r = -0.15), group 3 (P = 0.52; r = -0.17), and groups 1 and 3 analyzed as a whole (P = 0.14; r = -0.17). Conclusions: The indexed LA volume, impacting left ventricular preload, is correlated to the severity of emphysema.