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Long-term prognostic significance of left atrial volume in acute myocardial infarction

Roy Beinart1, Valentina Boyko, Ehud Schwammenthal

  • 1Heart Institute, Chaim Sheba Medical Center, Tel Hashomer, Israel.

Journal of the American College of Cardiology
|July 21, 2004
PubMed

Insights

Increased left atrial (LA) volume within 48 hours of acute myocardial infarction (MI) predicts long-term mortality. This finding provides valuable prognostic information beyond standard clinical and echocardiographic data for acute MI patients.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Prognostics

Background:

  • Left atrial (LA) volume reflects left ventricular (LV) diastolic properties.
  • LA volume is a stable measure of diastolic function, unaffected by acute changes in LV function post-myocardial infarction (MI).

Purpose of the Study:

  • To assess the prognostic significance of elevated LA volume within 48 hours of acute MI admission.
  • To determine if LA volume serves as a long-term predictor of mortality in acute MI patients.

Main Methods:

  • Prospective collection of clinical and echocardiographic data from 395 acute MI patients.
  • Comparison of patients with elevated LA volume index (LAVI >32 ml/m²) versus normal LAVI (<==32 ml/m²).
  • Utilized Cox proportional hazard model to identify independent predictors of five-year mortality.

Main Results:

  • Patients with elevated LAVI (>32 ml/m²) showed higher rates of congestive heart failure, mitral regurgitation, increased LV dimensions, and reduced LV ejection fraction.
  • Five-year mortality was significantly higher in the elevated LAVI group (34.5%) compared to the normal LAVI group (14.2%).
  • Independent predictors of five-year mortality included age, Killip class >=2, elevated LAVI, diabetes, and LV restrictive filling pattern.

Conclusions:

  • Elevated LA volume, measured within 48 hours of acute MI, is an independent predictor of five-year mortality.
  • Increased LA volume provides incremental prognostic value beyond existing clinical and echocardiographic assessments in acute MI patients.
Abstract

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