Korean J Med.  2014 Jan;86(1):33-41. 10.3904/kjm.2014.86.1.33.

Left Atrial Volume is a Predictor of Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction

Affiliations
  • 1The Heart Center of Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
  • 2The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
  • 3Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.
  • 4Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.

Abstract

BACKGROUND/AIMS
Diastolic dysfunction may develop in conjunction with or without systolic dysfunction in patients with acute myocardial infarction (AMI). The present study investigated the association between left arterial (LA) volume and major adverse cardiac events (MACE) in 772 patients with AMI.
METHODS
The patients were divided into groups according to LA volume index (LAVI) measured using echocardiography according to the American Society of Echocardiography guidelines: LAVI > or = 40 mL/m2 (Group I: n = 260, 191 males; age, 71.1 +/- 10.8 years) and LAVI < 40 mL/m2 (Group II: n = 512, 432 males; age, 62.8 +/- 12.7 years). The mean observational period was 314.2 +/- 134.6 days.
RESULTS
Group I patients were older than those in Group II. Hypertension (56.8% vs. 46.0%, respectively; p = 0.007) and advanced Killip class (42.6% vs. 21.0%, respectively; p < 0.001) were more frequent in Group I than in Group II. MACE was more prevalent in Group I than in Group II (20.3% vs. 13.7%, respectively; p = 0.037). MACE-free survival rates were higher in Group II than in Group I during clinical follow-up. The multivariate analysis revealed that high LAVI was an independent predictor of mortality (hazard ratio, 3.002; confidedce interval, 1.051-8.569; p = 0.040).
CONCLUSIONS
LA volume is an independent predictor of adverse cardiac events in patients with AMI, and the LAVI is useful for AMI risk stratification.

Keyword

Left atrium; Volume; Acute myocardial infarction; Prognosis

MeSH Terms

Echocardiography
Follow-Up Studies
Heart Atria
Humans
Hypertension
Male
Mortality
Multivariate Analysis
Myocardial Infarction*
Prognosis
Survival Rate
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