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Updated: Jun 11, 2025
08:10
Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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The Prognostic Value of Left Atrial Function in Patients with Acute Myocardial Infarction
Jorun Tangen1,2, Thuy Mi Nguyen1,2, Daniela Melichova1,3
1ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
Diagnostics (Basel, Switzerland)
|September 28, 2024
Summary
Left atrial strain offers valuable prognostic insights in acute myocardial infarction (AMI) patients, especially those with atrial fibrillation (AF). LA reservoir strain independently predicts adverse cardiovascular events, potentially outperforming traditional measures in AF patients.
Area of Science:
- Cardiology
- Echocardiography
- Cardiovascular Imaging
Background:
- Left atrial (LA) volume is a known prognostic marker in acute myocardial infarction (AMI).
- LA strain analysis offers deeper pathophysiological understanding.
- The incremental prognostic value of LA strain, particularly in patients with atrial fibrillation (AF), requires further investigation.
Purpose of the Study:
- To evaluate the prognostic value of LA volume and LA strain in AMI patients.
- To determine if LA strain provides additional prognostic information beyond LA volume and left ventricular global longitudinal strain (LV GLS).
- To assess the prognostic utility of LA strain specifically in AMI patients with AF.
Main Methods:
- Prospective study of 501 AMI patients undergoing two-dimensional echocardiography within 72 hours of admission.
- Primary outcome: composite of all-cause mortality and major adverse cardiovascular events.
- Cox regression analyses were used to assess independent predictors of the primary outcome.
Main Results:
- Left ventricular global longitudinal strain (LV GLS), indexed LA volume (LAVi), and LA reservoir strain were independently associated with the primary outcome.
- In the subgroup of 32 AF patients, LA reservoir strain remained a significant predictor, while LV GLS and LAVi did not.
- LA reservoir strain demonstrated prognostic value comparable to, and potentially superior to, LA volume and LV GLS in AF patients.
Conclusions:
- LA reservoir strain is an independent predictor of adverse cardiovascular events in AMI patients.
- LA strain analysis provides significant prognostic information, especially in AMI patients with AF.
- LA reservoir strain may offer superior prognostic capability compared to LA volume and LV GLS in the AF subgroup.
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