Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: A cardiovascular magnetic resonance study

Jacob Thomsen Lønborg, Thomas Engstrøm, Jacob Eifer Møller, Kiril A. Ahtarovski, Henning Kelbæk, Lene Holmvang, Erik Jørgensen, Steffen Helqvist, Kari Saunamäki, Helle Søholm, Mads Andersen, Anders B. Mathiasen, Jørgen Tobias Kühl, Peter Clemmensen, Lars Køber, Niels Vejlstrup

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstrakt

    AimsThe left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is based almost exclusively on LA maximal volume (LAmax), which may not glean the full prognostic potential. Cardiovascular magnetic resonance (CMR) is considered the most accurate method for studying LA function and size. The aim of the present study was to evaluate the prognostic importance of LA function in patients following ST elevation myocardial infarction (STEMI).Methods and resultsIn 199 patients, a CMR scan was performed within 1-3 days after STEMI to measure LAmax and minimal volume (LAmin) and LA function. The incidence of death, re-infarction, stroke, and admission for heart failure [major adverse cardiac event (MACE)] were registered during the follow-up period [2.3 years (inter-quartile range: 2.0-2.5)]. A total of 40 patients (20%) met the clinical endpoint of MACE during follow-up. In a Cox regression analysis adjusting for known risk factors, LA fractional change remained independently associated with MACE [adjusted hazard ratio: 0.66 (95% confidence interval: 0.46-0.95)]. LAmax, LAmin, or LA passive fraction was not independently associated with MACE. Furthermore, LA fractional change provided incremental prognostic value to LAmax and other known predictors (Wald χ2 31.0 vs. 39.9, P= 0.016).ConclusionIn STEMI patients, impaired LA fractional change is independently associated with outcome and provide incremental prognostic information to established predictors including LAmax.

    OriginalsprogEngelsk
    Sider (fra-til)118-127
    Antal sider10
    TidsskriftEuropean Heart Journal Cardiovascular Imaging
    Vol/bind14
    Udgave nummer2
    DOI
    StatusUdgivet - 1 feb. 2013

    Fingeraftryk Udforsk hvilke forskningsemner 'Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: A cardiovascular magnetic resonance study' indeholder.

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