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Long-term prognostic significance of left atrial volume in acute myocardial infarction.
- Source :
-
Journal of the American College of Cardiology [J Am Coll Cardiol] 2004 Jul 21; Vol. 44 (2), pp. 327-34. - Publication Year :
- 2004
-
Abstract
- Objectives: The aim of this study was to evaluate the significance of increased left atrial (LA) volume determined within the first 48 h of admission as a long-term predictor of outcome in patients with acute myocardial infarction (MI).<br />Background: The LA volume reflects left ventricular (LV) diastolic properties. Whereas other LV Doppler diastolic characteristics are influenced by acute changes in LV function, LA volume is stable and reflects diastolic properties before MI.<br />Methods: Clinical and echocardiographic parameters were prospectively collected in 395 consecutive patients with acute MI. Patients with LA volume index (LAVI) >32 ml/m(2) (normal + 2 standard deviations) were compared with those with LAVI <==32 ml/m(2). Independent clinical and echocardiographic prognostic risk factors for five years' mortality were determined by the Cox proportional hazard model.<br />Results: Left atrial volume index >32 ml/m(2) was found in 63 patients (19%) who had a higher incidence of congestive heart failure on admission (24% vs. 12%, p < 0.01), a higher incidence of mitral regurgitation, increased LV dimensions, and reduced LV ejection fraction when compared with patients with LAVI <==32 ml/m(2). Their five-year mortality rate was 34.5% versus 14.2% (p < 0.001). Significant independent risk predictors of five years' mortality were age (10 years) (odds ratio [OR] 1.45; 95% confidence interval [CI]1.14 to 1.86), Killip class >/=2 on admission (OR 2.30; 95% CI 1.29 to 4.09), LAVI >32 ml/m(2) (OR 2.22; 95% CI 1.25 to 3.96), diabetes (OR 1.94; 95% CI 1.15 to 3.28), and LV restrictive filling pattern (OR 1.89; 95% CI 1.09 to 3.31).<br />Conclusions: In patients with acute MI, increased LA volume, determined within the first 48 h of admission, is an independent predictor of five-year mortality with incremental prognostic information to clinical and echocardiographic data.
- Subjects :
- Aged
Echocardiography
Female
Heart Failure etiology
Humans
Male
Middle Aged
Mitral Valve Insufficiency complications
Mitral Valve Insufficiency diagnostic imaging
Myocardial Infarction complications
Myocardial Infarction mortality
Prognosis
Risk Factors
Stroke Volume
Survival Rate
Ventricular Function, Left
Atrial Function, Left
Cardiac Volume
Myocardial Infarction physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0735-1097
- Volume :
- 44
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of the American College of Cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 15261927
- Full Text :
- https://doi.org/10.1016/j.jacc.2004.03.062