Left Atrial Function Determined by Echocardiography Predicts Incident Heart Failure in Patients With STEMI treated by Primary Percutaneous Coronary Intervention.
Aged
Aged, 80 and over
Atrial Function, Left
/ physiology
Cohort Studies
Echocardiography, Doppler
/ methods
Female
Follow-Up Studies
Heart Failure
/ diagnostic imaging
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
/ methods
Predictive Value of Tests
Prospective Studies
Risk Factors
ST Elevation Myocardial Infarction
/ diagnostic imaging
Treatment Outcome
Acute myocardial infarction
STEMI
echocardiography
left atrial emptying fraction
left atrial function
left atrial volume
predictor
prognosis
risk stratification
Journal
Journal of cardiac failure
ISSN: 1532-8414
Titre abrégé: J Card Fail
Pays: United States
ID NLM: 9442138
Informations de publication
Date de publication:
Jan 2020
Jan 2020
Historique:
received:
13
03
2019
revised:
30
06
2019
accepted:
19
08
2019
pubmed:
28
8
2019
medline:
16
4
2021
entrez:
28
8
2019
Statut:
ppublish
Résumé
To assess the comparative effectiveness of left atrial (LA) functional parameters (left atrial emptying fraction (LAEF), left atrial expansion index (LAi) and minimal left atrial volume index (MinLAVI)) with that of LA volume index (LAVI) in predicting heart failure (HF) and death following ST-elevated myocardial infarction (STEMI). HF is common following STEMI. Enlarged LA volume as determined by echocardiography predicts adverse outcome following STEMI. However, whether echocardiographic parameters of LA function, such as LAEF, LAi and MinLAVI, are superior to LAVI for predicting prognosis following STEMI is unknown. A total of 369 patients with STEMI but without atrial fibrillation or HF who were treated with primary percutaneous coronary intervention were prospectively enrolled in the period between September 2006 and December 2008. Patients underwent echocardiography shortly after STEMI. The maximal and minimal LA volumes were measured using the biplane area-length method. LAVI, MinLAVI (minimal LA volume indexed to body surface area), LAEF ((maximal LA volume-minimal LA volume)/maximal LA volume), and LAi ((maximal LA volume-minimal LA volume)/minimal LA volume) were calculated. The endpoint was a composite consisting of HF or death from any cause. During a median follow-up of 66 months (interquartile range: 50-73 months), 112 patients reached the endpoint (68 HFs, 44 deaths). Following adjustment for clinical, biochemical and echocardiographic variables, only LAEF remained an independent predictor of the composite outcome, whereas LAVI did not (LAEF: HR 1.25, P = 0.043, per 1 SD decrease) (LAVI: HR 1.01, P = 0.91, per 1 SD increase). In patients with STEMI who were treated with primary percutaneous coronary intervention, LAEF, as measured by echocardiography shortly after infarction, was superior to LAVI in predicting incident HF and death.
Sections du résumé
OBJECTIVES
OBJECTIVE
To assess the comparative effectiveness of left atrial (LA) functional parameters (left atrial emptying fraction (LAEF), left atrial expansion index (LAi) and minimal left atrial volume index (MinLAVI)) with that of LA volume index (LAVI) in predicting heart failure (HF) and death following ST-elevated myocardial infarction (STEMI).
BACKGROUND
BACKGROUND
HF is common following STEMI. Enlarged LA volume as determined by echocardiography predicts adverse outcome following STEMI. However, whether echocardiographic parameters of LA function, such as LAEF, LAi and MinLAVI, are superior to LAVI for predicting prognosis following STEMI is unknown.
METHODS AND RESULTS
RESULTS
A total of 369 patients with STEMI but without atrial fibrillation or HF who were treated with primary percutaneous coronary intervention were prospectively enrolled in the period between September 2006 and December 2008. Patients underwent echocardiography shortly after STEMI. The maximal and minimal LA volumes were measured using the biplane area-length method. LAVI, MinLAVI (minimal LA volume indexed to body surface area), LAEF ((maximal LA volume-minimal LA volume)/maximal LA volume), and LAi ((maximal LA volume-minimal LA volume)/minimal LA volume) were calculated. The endpoint was a composite consisting of HF or death from any cause. During a median follow-up of 66 months (interquartile range: 50-73 months), 112 patients reached the endpoint (68 HFs, 44 deaths). Following adjustment for clinical, biochemical and echocardiographic variables, only LAEF remained an independent predictor of the composite outcome, whereas LAVI did not (LAEF: HR 1.25, P = 0.043, per 1 SD decrease) (LAVI: HR 1.01, P = 0.91, per 1 SD increase).
CONCLUSION
CONCLUSIONS
In patients with STEMI who were treated with primary percutaneous coronary intervention, LAEF, as measured by echocardiography shortly after infarction, was superior to LAVI in predicting incident HF and death.
Identifiants
pubmed: 31454686
pii: S1071-9164(19)30273-8
doi: 10.1016/j.cardfail.2019.08.014
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
35-42Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.