Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study

Jacob Thomsen Lønborg; Thomas Engstrøm; Jacob Eifer Møller; Kiril A Ahtarovski; Henning Kelbæk; Lene Holmvang; Erik Jørgensen; Steffen Helqvist; Kari Saunamäki; Helle Søholm; Mads Andersen; Anders B Mathiasen; Jørgen Tobias Kühl; Peter Clemmensen; Lars Køber; Niels Vejlstrup

doi:10.1093/ehjci/jes118

Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study

Jacob Thomsen Lønborg, Thomas Engstrøm, Jacob Eifer Møller, Kiril A Ahtarovski, Henning Kelbæk, Lene Holmvang, Erik Jørgensen, Steffen Helqvist, Kari Saunamäki, Helle Søholm, Mads Andersen, Anders B Mathiasen, Jørgen Tobias Kühl, Peter Clemmensen, Lars Køber, Niels Vejlstrup

Department of Clinical Medicine

52 Citations (Scopus)

Abstract

AimsThe left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is based almost exclusively on LA maximal volume (LAmax), which may not glean the full prognostic potential. Cardiovascular magnetic resonance (CMR) is considered the most accurate method for studying LA function and size. The aim of the present study was to evaluate the prognostic importance of LA function in patients following ST elevation myocardial infarction (STEMI).Methods and resultsIn 199 patients, a CMR scan was performed within 1-3 days after STEMI to measure LAmax and minimal volume (LAmin) and LA function. The incidence of death, re-infarction, stroke, and admission for heart failure [major adverse cardiac event (MACE)] were registered during the follow-up period [2.3 years (inter-quartile range: 2.0-2.5)]. A total of 40 patients (20%) met the clinical endpoint of MACE during follow-up. In a Cox regression analysis adjusting for known risk factors, LA fractional change remained independently associated with MACE [adjusted hazard ratio: 0.66 (95% confidence interval: 0.46-0.95)]. LAmax, LAmin, or LA passive fraction was not independently associated with MACE. Furthermore, LA fractional change provided incremental prognostic value to LAmax and other known predictors (Wald χ² 31.0 vs. 39.9, P= 0.016).ConclusionIn STEMI patients, impaired LA fractional change is independently associated with outcome and provide incremental prognostic information to established predictors including LAmax.

Original language	English
Journal	European Heart Journal Cardiovascular Imaging
Volume	14
Issue number	2
Pages (from-to)	118-27
Number of pages	10
ISSN	1525-2167
DOIs	https://doi.org/10.1093/ehjci/jes118
Publication status	Published - Feb 2013

Access to Document

10.1093/ehjci/jes118

https://academic.oup.com/ehjcimaging/article-pdf/14/2/118/9706054/jes118.pdf

Cite this

Lønborg, J. T., Engstrøm, T., Møller, J. E., Ahtarovski, K. A., Kelbæk, H., Holmvang, L., Jørgensen, E., Helqvist, S., Saunamäki, K., Søholm, H., Andersen, M., Mathiasen, A. B., Kühl, J. T., Clemmensen, P., Køber, L., & Vejlstrup, N. (2013). Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study . European Heart Journal Cardiovascular Imaging, 14(2), 118-27. https://doi.org/10.1093/ehjci/jes118

Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome : a cardiovascular magnetic resonance study . / Lønborg, Jacob Thomsen; Engstrøm, Thomas; Møller, Jacob Eifer et al.

In: European Heart Journal Cardiovascular Imaging, Vol. 14, No. 2, 02.2013, p. 118-27.

Research output: Contribution to journal › Journal article › Research › peer-review

Lønborg, JT, Engstrøm, T, Møller, JE, Ahtarovski, KA, Kelbæk, H, Holmvang, L, Jørgensen, E, Helqvist, S, Saunamäki, K, Søholm, H, Andersen, M, Mathiasen, AB, Kühl, JT, Clemmensen, P, Køber, L & Vejlstrup, N 2013, 'Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study ', European Heart Journal Cardiovascular Imaging, vol. 14, no. 2, pp. 118-27. https://doi.org/10.1093/ehjci/jes118

@article{7995e34d889144008443ed3434df6353,

title = "Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study ",

abstract = "AimsThe left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is based almost exclusively on LA maximal volume (LAmax), which may not glean the full prognostic potential. Cardiovascular magnetic resonance (CMR) is considered the most accurate method for studying LA function and size. The aim of the present study was to evaluate the prognostic importance of LA function in patients following ST elevation myocardial infarction (STEMI).Methods and resultsIn 199 patients, a CMR scan was performed within 1-3 days after STEMI to measure LAmax and minimal volume (LAmin) and LA function. The incidence of death, re-infarction, stroke, and admission for heart failure [major adverse cardiac event (MACE)] were registered during the follow-up period [2.3 years (inter-quartile range: 2.0-2.5)]. A total of 40 patients (20%) met the clinical endpoint of MACE during follow-up. In a Cox regression analysis adjusting for known risk factors, LA fractional change remained independently associated with MACE [adjusted hazard ratio: 0.66 (95% confidence interval: 0.46-0.95)]. LAmax, LAmin, or LA passive fraction was not independently associated with MACE. Furthermore, LA fractional change provided incremental prognostic value to LAmax and other known predictors (Wald χ2 31.0 vs. 39.9, P= 0.016).ConclusionIn STEMI patients, impaired LA fractional change is independently associated with outcome and provide incremental prognostic information to established predictors including LAmax.",

author = "L{\o}nborg, {Jacob Thomsen} and Thomas Engstr{\o}m and M{\o}ller, {Jacob Eifer} and Ahtarovski, {Kiril A} and Henning Kelb{\ae}k and Lene Holmvang and Erik J{\o}rgensen and Steffen Helqvist and Kari Saunam{\"a}ki and Helle S{\o}holm and Mads Andersen and Mathiasen, {Anders B} and K{\"u}hl, {J{\o}rgen Tobias} and Peter Clemmensen and Lars K{\o}ber and Niels Vejlstrup",

year = "2013",

month = feb,

doi = "10.1093/ehjci/jes118",

language = "English",

volume = "14",

pages = "118--27",

journal = "European Heart Journal Cardiovascular Imaging",

issn = "2047-2404",

publisher = "Oxford University Press",

number = "2",

}

TY - JOUR

T1 - Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome

T2 - a cardiovascular magnetic resonance study

AU - Lønborg, Jacob Thomsen

AU - Engstrøm, Thomas

AU - Møller, Jacob Eifer

AU - Ahtarovski, Kiril A

AU - Kelbæk, Henning

AU - Holmvang, Lene

AU - Jørgensen, Erik

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Søholm, Helle

AU - Andersen, Mads

AU - Mathiasen, Anders B

AU - Kühl, Jørgen Tobias

AU - Clemmensen, Peter

AU - Køber, Lars

AU - Vejlstrup, Niels

PY - 2013/2

Y1 - 2013/2

N2 - AimsThe left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is based almost exclusively on LA maximal volume (LAmax), which may not glean the full prognostic potential. Cardiovascular magnetic resonance (CMR) is considered the most accurate method for studying LA function and size. The aim of the present study was to evaluate the prognostic importance of LA function in patients following ST elevation myocardial infarction (STEMI).Methods and resultsIn 199 patients, a CMR scan was performed within 1-3 days after STEMI to measure LAmax and minimal volume (LAmin) and LA function. The incidence of death, re-infarction, stroke, and admission for heart failure [major adverse cardiac event (MACE)] were registered during the follow-up period [2.3 years (inter-quartile range: 2.0-2.5)]. A total of 40 patients (20%) met the clinical endpoint of MACE during follow-up. In a Cox regression analysis adjusting for known risk factors, LA fractional change remained independently associated with MACE [adjusted hazard ratio: 0.66 (95% confidence interval: 0.46-0.95)]. LAmax, LAmin, or LA passive fraction was not independently associated with MACE. Furthermore, LA fractional change provided incremental prognostic value to LAmax and other known predictors (Wald χ2 31.0 vs. 39.9, P= 0.016).ConclusionIn STEMI patients, impaired LA fractional change is independently associated with outcome and provide incremental prognostic information to established predictors including LAmax.

AB - AimsThe left atrium (LA) transfers blood to the left ventricle in a complex manner. LA function is characterized by passive emptying (LA passive fraction), active emptying (LA ejection fraction), and total emptying (LA fractional change). Despite this complexity, the clinical relevance of the LA is based almost exclusively on LA maximal volume (LAmax), which may not glean the full prognostic potential. Cardiovascular magnetic resonance (CMR) is considered the most accurate method for studying LA function and size. The aim of the present study was to evaluate the prognostic importance of LA function in patients following ST elevation myocardial infarction (STEMI).Methods and resultsIn 199 patients, a CMR scan was performed within 1-3 days after STEMI to measure LAmax and minimal volume (LAmin) and LA function. The incidence of death, re-infarction, stroke, and admission for heart failure [major adverse cardiac event (MACE)] were registered during the follow-up period [2.3 years (inter-quartile range: 2.0-2.5)]. A total of 40 patients (20%) met the clinical endpoint of MACE during follow-up. In a Cox regression analysis adjusting for known risk factors, LA fractional change remained independently associated with MACE [adjusted hazard ratio: 0.66 (95% confidence interval: 0.46-0.95)]. LAmax, LAmin, or LA passive fraction was not independently associated with MACE. Furthermore, LA fractional change provided incremental prognostic value to LAmax and other known predictors (Wald χ2 31.0 vs. 39.9, P= 0.016).ConclusionIn STEMI patients, impaired LA fractional change is independently associated with outcome and provide incremental prognostic information to established predictors including LAmax.

U2 - 10.1093/ehjci/jes118

DO - 10.1093/ehjci/jes118

M3 - Journal article

C2 - 22696494

SN - 2047-2404

VL - 14

SP - 118

EP - 127

JO - European Heart Journal Cardiovascular Imaging

JF - European Heart Journal Cardiovascular Imaging

IS - 2

ER -

Left atrial volume and function in patients following ST elevation myocardial infarction and the association with clinical outcome: a cardiovascular magnetic resonance study

Abstract

Access to Document

Fingerprint

Cite this