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Prognostic value of left atrium remodeling after primary percutaneous coronary intervention in patients with ST
Jang Hyun Cho1, Su Hyun Kim, Cheol hwan Kim
1Division of Cardiology, Department of Internal Medicine, St. Carollo Hospital, Suncheon, Korea.
Insights
Changes in left atrial size after acute myocardial infarction (AMI) predict future cardiac events. Monitoring left atrial volume index (LAVI) post-AMI offers crucial prognostic insights beyond traditional markers.
Area of Science:
- Cardiology
- Echocardiography
- Cardiac Imaging
Background:
- Left atrial (LA) size is a recognized indicator of cardiovascular health.
- Acute myocardial infarction (AMI) significantly impacts cardiac remodeling and function.
- Long-term prognostic markers following percutaneous coronary intervention (PCI) are crucial for patient management.
Purpose of the Study:
- To investigate the association between left atrial (LA) size and patient outcomes after acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI).
- To evaluate the dynamic changes in LA size during long-term follow-up after AMI.
- To determine if changes in LA volume index (LAVI) predict adverse cardiac events.
Main Methods:
- Echocardiographic analysis of 253 AMI patients undergoing primary PCI.
- Measurement of left atrial volume index (LAVI) at baseline (AMI onset) and at 12 months.
- Clinical follow-up for an average of 30.8 months.
Main Results:
- A change in LAVI independently predicted new-onset atrial fibrillation or hospitalization for heart failure (P = 0.002).
- Patients surviving 12 months showed a significant increase in mean LAVI (26.1 to 28.0 mL/m², P < 0.001).
- Increased LAVI correlated with reduced left ventricular ejection fraction, larger ventricular dimensions, and enlarged LA size.
Conclusions:
- Changes in LAVI serve as a valuable parameter for predicting subsequent adverse cardiac events in AMI patients.
- Post-AMI echocardiographic assessment of LAVI provides prognostic information superior to clinical and laboratory parameters alone.
- Dynamic monitoring of LA size offers critical insights into long-term outcomes after AMI.
Abstract:
The purpose of this study is to assess the relationship between left atrial (LA) size and outcome after acute myocardial infarction (AMI) in patients undergoing primary percutaneous coronary intervention (PCI) and to evaluate dynamic changes in LA size during long-term follow-up. Echocardiographic analyses were performed on 253 AMI patients (174 male and 79 female, 65.4 ± 13.7 yr) undergoing PCI. These subjects were studied at baseline and at 12 months. Clinical follow-up were done at 30.8 ± 7.5 months. We assessed LA volume index (LAVI) at AMI-onset and at 12-month. Change of LAVI was an independent predictor of new onset of atrial fibrillation or hospitalization for heart failure (P = 0.002). Subjects who survived the 12-month period displayed an increased LAVI mean of 1.86 ± 4.01 mL/m(2) (from 26.1 ± 8.6 to 28.0 ± 10.1 mL/m(2), P < 0.001). The subject group that displayed an increased LAVI correlated with a low left ventricular ejection fraction, large left ventricle systolic and diastolic dimensions and an enlarged LA size. In conclusion, change of LAVI is useful parameter to predict subsequent adverse cardiac event in AMI patients. Post-AMI echocardiographic evaluation of LAVI provides important prognostic information that is significantly greater than that obtained from clinical and laboratory parameters alone.
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