Left atrial remodelling in patients with myocardial infarction complicated by heart failure, left ventricular
Alessandra Meris1, Maria Amigoni, Hajime Uno
1Cardiovascular Division, Brigham and Women's Hospital, MA, USA.
European Heart Journal
|November 13, 2008
Summary
Left atrial size predicts adverse outcomes after high-risk myocardial infarction (MI). Early LA enlargement in the first month post-MI is linked to increased risk of death or heart failure hospitalization.
Area of Science:
- Cardiology
- Echocardiography
- Clinical Outcomes
Background:
- Left ventricular (LV) dysfunction and heart failure (HF) are common after myocardial infarction (MI).
- Left atrial (LA) size is a potential indicator of cardiac health and remodeling.
Purpose of the Study:
- To evaluate the association between LA size and outcomes in high-risk MI patients.
- To investigate dynamic changes in LA size over long-term follow-up.
Main Methods:
- Prospective enrollment of 610 patients from the VALIANT Echocardiography study post-MI.
- Assessment of LA volume indexed to body surface area (LAVi) at baseline, 1 month, and 20 months.
- Statistical analysis to identify predictors of outcomes and LA remodeling.
Main Results:
- Baseline LAVi independently predicted all-cause death or HF hospitalization (P = 0.004).
- LA volume increased in patients surviving to 20 months, with early enlargement linked to adverse events.
- Hypertension, reduced eGFR, and LV mass predicted LA remodeling, which correlated with worsening mitral regurgitation and LV volumes.
Conclusions:
- Baseline LA size is a significant predictor of mortality and HF hospitalization post-high-risk MI.
- LA remodeling within the first month after MI is associated with poorer clinical outcomes.
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