Back ground:LA volume index(LAVi) provides excellent sensitivity and specificity for the detection of severe diastolic dysfunction (DD). However, it is poor marker to assess a status of mild to moderate DD. Objective:We assessed the clinical usefulness of LAVi/A���to predict the adverse cardiovascular events in patients with mild DD. Methods:The study population consisted of 364 patients with grade I DD and sinus rhythm (mean age 64짹11yrs, 53.6%men) who underwent Doppler echocardiography and BNP measurement.During follow-up,the incidence of the composite events of cardiac death or re-hospitalization were compared based on the LAVi/A' cut-off value of 4.0, which means elevated LV filling pressure in our previous study. Results: During a median follow-up of 12.8짹4.3 months, the incidence of composite events was 9,3% (cardiac death, n=4 and re-hospitalization, n=30). The patients of LAVi/A������4 had a higher BNP level (317.02 pg/ml vs 105.85 pg/ml), lower EF(53.6% vs 60.5%), higher E/E (11.8 vs 8.75) (all p<0.001) than those of LAVi/A���<4. In Kaplan-Meier curves, the incidence of composite events was higher in patients with LAVi/A������4 than those with LAVi/A���<4 (figure 1). In Cox proportional hazards analysis, LAVi/A������4 (OR:2.85,95%CI1.24-6.51,p=0.013), creatinine level(OR:1.39,95%CI1.03-1.86, p=0.029),hemoglobin (OR:0.67,95%CI0.57-0.78,p<0.001) were independent predictors of clinical outcomes. conclusion: LAVi/A������4 is a very useful parameter to predict clinical outcomes in patients with mild DD.