Tangen Jorun, Nguyen Thuy Mi, Melichova Daniela, Klaeboe Lars Gunnar, Forsa Marianne, Andresen Kristoffer, Wazzan Adrien Al, Lie Oyvind, Haugaa Kristina, Skulstad Helge, Brunvand Harald, Edvardsen Thor
ProCardio Center for Innovation, Department of Cardiology, Oslo University Hospital, Rikshospitalet, P.O. Box 4950 Nydalen, 0424 Oslo, Norway.
Institute for Clinical Medicine, University of Oslo, Sognsvannsveien 9, 0373 Oslo, Norway.
Diagnostics (Basel). 2024 Sep 13;14(18):2027. doi: 10.3390/diagnostics14182027.
The prognostic value of left atrial (LA) volume is well-established in acute myocardial infarction (AMI) patients. LA strain provides further patophysological insights. In the present study, we evaluated LA volume and LA strain in AMI patients including those with atrial fibrillation (AF). The aim of the study was to determine if LA strain provide additional prognostic value. Patients with AMI underwent two-dimensional echocardiography within 72 h of admission. The primary outcome was a composite of all-cause mortality and major adverse cardiovascular events. Cox regression analyses were performed. We included 501 patients and during follow-up, 132 patients (26.4%) met the primary outcome. Left ventricular (LV) global longitudinal strain (GLS) (HR 0.94 [95% CI 0.88-0.99], = 0.029), indexed LA volume (LAVi) (HR 1.02 [95% CI 1.00-1.04], = 0.015), and LA reservoir strain (HR 0.96 [95% CI 0.93-0.99], = 0.017) were all independently associated with the primary outcome. A univariate Cox model conducted on the AF patients ( = 32) revealed that LA reservoir strain remained significantly associated with the primary outcome, while LV GLS and LAVi were not significant. The prognostic value of LA reservoir strain was comparable to LA volume and LV GLS, and might even be better in AF patients.
左心房（LA）容积在急性心肌梗死（AMI）患者中的预后价值已得到充分证实。LA应变提供了进一步的病理生理学见解。在本研究中，我们评估了AMI患者（包括合并心房颤动（AF）的患者）的LA容积和LA应变。本研究的目的是确定LA应变是否具有额外的预后价值。AMI患者在入院72小时内接受了二维超声心动图检查。主要结局是全因死亡率和主要不良心血管事件的复合结局。进行了Cox回归分析。我们纳入了501例患者，在随访期间，132例患者（26.4%）达到了主要结局。左心室（LV）整体纵向应变（GLS）（风险比[HR]0.94[95%置信区间（CI）0.88 - 0.99]，P = 0.029）、左心房容积指数（LAVi）（HR 1.02[95% CI 1.00 - 1.04]，P = 0.015）和LA储存应变（HR 0.96[95% CI 0.93 - 0.99]，P = 0.017）均与主要结局独立相关。对AF患者（n = 32）进行的单变量Cox模型显示，LA储存应变仍与主要结局显著相关，而LV GLS和LAVi不显著。LA储存应变的预后价值与LA容积和LV GLS相当，在AF患者中甚至可能更好。
