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Left atrial volume: a powerful predictor of survival after acute myocardial infarction

Jacob E Moller1, Graham S Hillis, Jae K Oh

  • 1Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, Minn 55905, USA.

Circulation
|April 16, 2003
PubMed

Insights

Increased left atrial (LA) volume index after acute myocardial infarction (AMI) strongly predicts mortality. This measurement offers crucial prognostic information beyond standard clinical assessments and left ventricular (LV) function tests.

Area of Science:

  • Cardiology
  • Echocardiography
  • Prognostics

Background:

  • Diastolic function post-acute myocardial infarction (AMI) is prognostically important but Doppler assessment is variable.
  • Left atrial (LA) volume offers a more stable reflection of subacute or chronic diastolic function.
  • Assessing risk in AMI patients may benefit from stable diastolic function markers.

Purpose of the Study:

  • To evaluate the prognostic value of left atrial (LA) volume index in patients following acute myocardial infarction (AMI).
  • To determine if LA volume index provides incremental prognostic information beyond established clinical and echocardiographic parameters.

Main Methods:

  • Transthoracic echocardiograms were performed on 314 AMI patients during admission.
  • Left ventricular (LV) systolic and diastolic function, and LA volume index (adjusted for body surface area) were assessed.
  • Patients were stratified by LA volume index >32 mL/m2; all-cause mortality was tracked over a median of 15 months.

Main Results:

  • A total of 142 patients (45%) had an elevated LA volume index (>32 mL/m2).
  • During follow-up, 46 patients (15%) died from all causes.
  • Elevated LA volume index was a significant independent predictor of mortality (HR 1.05 per 1-mL/m2 increase, P<0.001), even after adjusting for clinical factors and LV function.

Conclusions:

  • Increased LA volume index is a powerful predictor of mortality post-AMI.
  • LA volume index offers prognostic information that is incremental to clinical data and conventional LV systolic and diastolic function measures.
Abstract

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