Department of Cardiology, Leiden University Medical Center, The Netherlands.
Heart. 2011 Aug;97(16):1332-7. doi: 10.1136/hrt.2011.227678. Epub 2011 May 25.
Left atrial (LA) maximal volume is of prognostic value in patients after acute myocardial infarction (AMI). Recently, LA mechanical function and LA strain have been introduced as alternative methods to assess LA performance more accurately.
To evaluate the relation between LA volume, mechanical function and strain, and adverse events in patients after AMI.
Patients with AMI underwent two-dimensional echocardiography within 48 h of admission. LA volume and LA performance (mechanical function and systolic strain) were quantified. The endpoint was a composite of all-cause mortality, reinfarction and hospitalisation for heart failure.
320 patients (mean age 60±12 years, 78% men) were followed up for 27±14 months. During follow-up, 48 patients (15%) reached the composite endpoint. After adjustment for clinical and echocardiographic parameters, LA maximal volume (HR 1.05, CI 1.00 to 1.10, p=0.04) and LA strain (HR 0.94, CI 0.89 to 0.99, p=0.02) were independently associated with adverse outcome. In addition, LA strain provided incremental value to LA maximal volume (p=0.03) for the prediction of adverse outcome.
After AMI treated with primary percutaneous coronary intervention, LA strain provides additional prognostic value beyond LA maximal volume.
左心房（LA）最大容积在急性心肌梗死（AMI）后患者的预后中有价值。最近，LA 机械功能和 LA 应变已被引入，作为更准确地评估 LA 性能的替代方法。
评估 AMI 后患者的 LA 容积、机械功能和应变与不良事件之间的关系。
AMI 患者在入院后 48 小时内进行二维超声心动图检查。定量评估 LA 容积和 LA 性能（机械功能和收缩期应变）。终点是全因死亡率、再梗死和心力衰竭住院的复合终点。
320 例患者（平均年龄 60±12 岁，78%为男性）随访 27±14 个月。随访期间，48 例（15%）达到复合终点。在调整临床和超声心动图参数后，LA 最大容积（HR 1.05，CI 1.00 至 1.10，p=0.04）和 LA 应变（HR 0.94，CI 0.89 至 0.99，p=0.02）与不良结局独立相关。此外，LA 应变较 LA 最大容积（p=0.03）能提供额外的预后价值。
在接受经皮冠状动脉介入治疗的 AMI 后，LA 应变比 LA 最大容积提供了额外的预后价值。
