Left atrial volume: a powerful predictor of survival after acute myocardial infarction

J. E. Moller, Graham Scott Hillis, J. K. Oh, J. B. Seward, G. S. Reeder, R. S. Wright, S. W. Park, K. Bailey, P. A. Pellikka

    Research output: Contribution to journalArticle

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    Abstract

    Background - After acute myocardial infarction ( AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, Doppler variables are affected by multiple factors and may change rapidly. In contrast, left atrial ( LA) volume is less influenced by acute changes and reflects subacute or chronic diastolic function. This may be of importance when one assesses risk in patients with AMI.

    Methods and Results - Three hundred fourteen patients with AMI who had a transthoracic echocardiogram with assessment of left ventricular (LV) systolic and diastolic function and measurement of LA volume during admission were identified. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m(2) ( 2 SDs above normal). LA volume index was >32 mL/m(2) in 142 (45%). The primary study end point was all-cause mortality. During follow-up of 15 ( range 0 to 33) months, 46 patients (15%) died. LA volume index was a powerful predictor of mortality and remained an independent predictor ( hazard ratio 1.05 per 1- mL/m(2) change, 95% CI 1.03 to 1.06, P < 0.001) after adjustment for clinical factors, LV systolic function, and Doppler-derived parameters of diastolic function.

    Conclusions - Increased LA volume index is a powerful predictor of mortality after AMI and provides prognostic information incremental to clinical data and conventional measures of LV systolic and diastolic function.

    Original languageEnglish
    Pages (from-to)2207-2212
    Number of pages5
    JournalCirculation
    Volume107
    DOIs
    Publication statusPublished - Apr 2003

    Keywords

    • atrium
    • myocardial infarction
    • echocardiography
    • diastole
    • LEFT-VENTRICULAR DYSFUNCTION
    • MITRAL DECELERATION TIME
    • DOPPLER-ECHOCARDIOGRAPHY
    • PROGNOSTIC VALUE
    • DIASTOLIC FUNCTION
    • NATRIURETIC PEPTIDE
    • HEART-FAILURE
    • CONTRACTION
    • DIFFERENCE
    • DURATION

    Cite this

    Moller, J. E., Hillis, G. S., Oh, J. K., Seward, J. B., Reeder, G. S., Wright, R. S., ... Pellikka, P. A. (2003). Left atrial volume: a powerful predictor of survival after acute myocardial infarction. Circulation, 107, 2207-2212. https://doi.org/10.1161/01.CIR.0000066318.21784.43

    Left atrial volume: a powerful predictor of survival after acute myocardial infarction. / Moller, J. E.; Hillis, Graham Scott; Oh, J. K.; Seward, J. B.; Reeder, G. S.; Wright, R. S.; Park, S. W.; Bailey, K.; Pellikka, P. A.

    In: Circulation, Vol. 107, 04.2003, p. 2207-2212.

    Research output: Contribution to journalArticle

    Moller, JE, Hillis, GS, Oh, JK, Seward, JB, Reeder, GS, Wright, RS, Park, SW, Bailey, K & Pellikka, PA 2003, 'Left atrial volume: a powerful predictor of survival after acute myocardial infarction' Circulation, vol. 107, pp. 2207-2212. https://doi.org/10.1161/01.CIR.0000066318.21784.43
    Moller, J. E. ; Hillis, Graham Scott ; Oh, J. K. ; Seward, J. B. ; Reeder, G. S. ; Wright, R. S. ; Park, S. W. ; Bailey, K. ; Pellikka, P. A. / Left atrial volume: a powerful predictor of survival after acute myocardial infarction. In: Circulation. 2003 ; Vol. 107. pp. 2207-2212.
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    title = "Left atrial volume: a powerful predictor of survival after acute myocardial infarction",
    abstract = "Background - After acute myocardial infarction ( AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, Doppler variables are affected by multiple factors and may change rapidly. In contrast, left atrial ( LA) volume is less influenced by acute changes and reflects subacute or chronic diastolic function. This may be of importance when one assesses risk in patients with AMI.Methods and Results - Three hundred fourteen patients with AMI who had a transthoracic echocardiogram with assessment of left ventricular (LV) systolic and diastolic function and measurement of LA volume during admission were identified. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m(2) ( 2 SDs above normal). LA volume index was >32 mL/m(2) in 142 (45{\%}). The primary study end point was all-cause mortality. During follow-up of 15 ( range 0 to 33) months, 46 patients (15{\%}) died. LA volume index was a powerful predictor of mortality and remained an independent predictor ( hazard ratio 1.05 per 1- mL/m(2) change, 95{\%} CI 1.03 to 1.06, P < 0.001) after adjustment for clinical factors, LV systolic function, and Doppler-derived parameters of diastolic function.Conclusions - Increased LA volume index is a powerful predictor of mortality after AMI and provides prognostic information incremental to clinical data and conventional measures of LV systolic and diastolic function.",
    keywords = "atrium, myocardial infarction, echocardiography, diastole, LEFT-VENTRICULAR DYSFUNCTION, MITRAL DECELERATION TIME, DOPPLER-ECHOCARDIOGRAPHY, PROGNOSTIC VALUE, DIASTOLIC FUNCTION, NATRIURETIC PEPTIDE, HEART-FAILURE, CONTRACTION, DIFFERENCE, DURATION",
    author = "Moller, {J. E.} and Hillis, {Graham Scott} and Oh, {J. K.} and Seward, {J. B.} and Reeder, {G. S.} and Wright, {R. S.} and Park, {S. W.} and K. Bailey and Pellikka, {P. A.}",
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    TY - JOUR

    T1 - Left atrial volume: a powerful predictor of survival after acute myocardial infarction

    AU - Moller, J. E.

    AU - Hillis, Graham Scott

    AU - Oh, J. K.

    AU - Seward, J. B.

    AU - Reeder, G. S.

    AU - Wright, R. S.

    AU - Park, S. W.

    AU - Bailey, K.

    AU - Pellikka, P. A.

    PY - 2003/4

    Y1 - 2003/4

    N2 - Background - After acute myocardial infarction ( AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, Doppler variables are affected by multiple factors and may change rapidly. In contrast, left atrial ( LA) volume is less influenced by acute changes and reflects subacute or chronic diastolic function. This may be of importance when one assesses risk in patients with AMI.Methods and Results - Three hundred fourteen patients with AMI who had a transthoracic echocardiogram with assessment of left ventricular (LV) systolic and diastolic function and measurement of LA volume during admission were identified. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m(2) ( 2 SDs above normal). LA volume index was >32 mL/m(2) in 142 (45%). The primary study end point was all-cause mortality. During follow-up of 15 ( range 0 to 33) months, 46 patients (15%) died. LA volume index was a powerful predictor of mortality and remained an independent predictor ( hazard ratio 1.05 per 1- mL/m(2) change, 95% CI 1.03 to 1.06, P < 0.001) after adjustment for clinical factors, LV systolic function, and Doppler-derived parameters of diastolic function.Conclusions - Increased LA volume index is a powerful predictor of mortality after AMI and provides prognostic information incremental to clinical data and conventional measures of LV systolic and diastolic function.

    AB - Background - After acute myocardial infarction ( AMI), diastolic function assessed by Doppler echocardiography provides important prognostic information that is incremental to systolic function. However, Doppler variables are affected by multiple factors and may change rapidly. In contrast, left atrial ( LA) volume is less influenced by acute changes and reflects subacute or chronic diastolic function. This may be of importance when one assesses risk in patients with AMI.Methods and Results - Three hundred fourteen patients with AMI who had a transthoracic echocardiogram with assessment of left ventricular (LV) systolic and diastolic function and measurement of LA volume during admission were identified. The LA volume was corrected for body surface area, and the population was divided according to LA volume index of 32 mL/m(2) ( 2 SDs above normal). LA volume index was >32 mL/m(2) in 142 (45%). The primary study end point was all-cause mortality. During follow-up of 15 ( range 0 to 33) months, 46 patients (15%) died. LA volume index was a powerful predictor of mortality and remained an independent predictor ( hazard ratio 1.05 per 1- mL/m(2) change, 95% CI 1.03 to 1.06, P < 0.001) after adjustment for clinical factors, LV systolic function, and Doppler-derived parameters of diastolic function.Conclusions - Increased LA volume index is a powerful predictor of mortality after AMI and provides prognostic information incremental to clinical data and conventional measures of LV systolic and diastolic function.

    KW - atrium

    KW - myocardial infarction

    KW - echocardiography

    KW - diastole

    KW - LEFT-VENTRICULAR DYSFUNCTION

    KW - MITRAL DECELERATION TIME

    KW - DOPPLER-ECHOCARDIOGRAPHY

    KW - PROGNOSTIC VALUE

    KW - DIASTOLIC FUNCTION

    KW - NATRIURETIC PEPTIDE

    KW - HEART-FAILURE

    KW - CONTRACTION

    KW - DIFFERENCE

    KW - DURATION

    U2 - 10.1161/01.CIR.0000066318.21784.43

    DO - 10.1161/01.CIR.0000066318.21784.43

    M3 - Article

    VL - 107

    SP - 2207

    EP - 2212

    JO - Circulation

    JF - Circulation

    SN - 0009-7322

    ER -