J Korean Med Sci.  2012 Mar;27(3):236-242. 10.3346/jkms.2012.27.3.236.

Prognostic Value of Left Atrium Remodeling after Primary Percutaneous Coronary Intervention in Patients with ST Elevation Acute Myocardial Infarction

• Cho JH
• Kim SH
• Kim CH
• Park JY
• Choi S
• Yun MH
• Kim DH
• Mun JH
• Kim JY
• Yoon HJ
• Kim KH
• Jeong MH

• KMID: 1792992
• DOI: http://doi.org/10.3346/jkms.2012.27.3.236

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/m2 (from 26.1 +/- 8.6 to 28.0 +/- 10.1 mL/m2, 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.

Keyword

Echocardiography; Myocardial Infarction; Heart atria; Remodeling; Prognosis

MeSH Terms

Aged
*Angioplasty, Balloon, Coronary
Echocardiography
Female
Follow-Up Studies
Heart Atria/pathology/physiopathology/ultrasonography
Humans
Male
Middle Aged
Myocardial Infarction/*pathology/physiopathology/*therapy/ultrasonography
Prognosis
Time Factors

Figure

• 

  Fig. 1 New onset atrial fibrillation or hospitalization with heart failure according to change of LAVI (P value = 0.002).

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