Diastolic dysfunction predicts new-onset atrial fibrillation and cardiovascular events in patients with acute myocardial infarction and depressed left ventricular systolic function: a CARISMA substudy

TY - JOUR

T1 - Diastolic dysfunction predicts new-onset atrial fibrillation and cardiovascular events in patients with acute myocardial infarction and depressed left ventricular systolic function: a CARISMA substudy

AU - Jons, Christian

AU - Joergensen, Rikke Moerch

AU - Hassager, Christian

AU - Gang, Uffe Jakob Ortved

AU - Dixen, Ulrik

AU - Johannesen, Arne

AU - Olsen, Niels Thue

AU - Hansen, Thomas F

AU - Messier, Marc

AU - Huikuri, Heikki V

AU - Thomsen, Poul Erik Bloch

AU - Gang, Uffe Jacob Ortved

AU - Olsen, Niels Thue

PY - 2010/8/1

Y1 - 2010/8/1

N2 - Aims The aim of this study was to investigate the association between diastolic dysfunction and long-term occurrence of new-onset atrial fibrillation (AF) and cardiac events in patients with acute myocardial infarction (AMI) and left ventricular (LV) systolic dysfunction. Methods and results The study was performed as a substudy on the CARISMA study population. The CARISMA study enrolled 312 patients with an AMI and LV ejection fraction ≤40. Patients were implanted with an implantable loop recorder and followed for 2 years. Sixty-two patients had a full echocardiographic assessment of the diastolic function using tissue Doppler analysis performed 6 weeks after the AMI. The endpoints were: (i) new-onset AF and (ii) major cardiovascular events (MACE) defined as re-infarction, stroke, or cardiovascular death. Twenty-four patients had diastolic dysfunction, whereas 38 patients had normal diastolic function. Diastolic dysfunction was associated with an increased risk of new-onset AF [HR = 5.30 (1.68-16.75), P = 0.005] and MACE [HR = 4.70 (1.25-17.75), P = 0.022] after adjustment for age, sex, NYHA class, and hypertension. Conclusion Diastolic dysfunction in post-MI patients with LV systolic dysfunction predisposes to new-onset AF and MACE.

AB - Aims The aim of this study was to investigate the association between diastolic dysfunction and long-term occurrence of new-onset atrial fibrillation (AF) and cardiac events in patients with acute myocardial infarction (AMI) and left ventricular (LV) systolic dysfunction. Methods and results The study was performed as a substudy on the CARISMA study population. The CARISMA study enrolled 312 patients with an AMI and LV ejection fraction ≤40. Patients were implanted with an implantable loop recorder and followed for 2 years. Sixty-two patients had a full echocardiographic assessment of the diastolic function using tissue Doppler analysis performed 6 weeks after the AMI. The endpoints were: (i) new-onset AF and (ii) major cardiovascular events (MACE) defined as re-infarction, stroke, or cardiovascular death. Twenty-four patients had diastolic dysfunction, whereas 38 patients had normal diastolic function. Diastolic dysfunction was associated with an increased risk of new-onset AF [HR = 5.30 (1.68-16.75), P = 0.005] and MACE [HR = 4.70 (1.25-17.75), P = 0.022] after adjustment for age, sex, NYHA class, and hypertension. Conclusion Diastolic dysfunction in post-MI patients with LV systolic dysfunction predisposes to new-onset AF and MACE.

U2 - 10.1093/ejechocard/jeq024

DO - 10.1093/ejechocard/jeq024

M3 - Journal article

SN - 1525-2167

VL - 11

SP - 602

EP - 607

JO - European Journal of Echocardiography

JF - European Journal of Echocardiography

IS - 7

ER -