Details

Autor(en) / Beteiligte

• Madsen, Andreas Ruhvald
• Skaarup, Kristoffer Grundtvig
• Iversen, Allan Zeeberg
• Jørgensen, Peter Godsk
• Pedersson, Philip Rüssell
• Biering-Sørensen, Tor

Titel

Echocardiographic Measures of Left Atrial Structure and Function and the Association with Atrial Fibrillation following Acute Coronary Syndrome

Ist Teil von

• Cardiology, 2023-07, Vol.148 (3), p.207-218

Ort / Verlag

Basel, Switzerland

Erscheinungsjahr

2023

Quelle

MEDLINE

Beschreibungen/Notizen

• Introduction: Acute coronary syndrome (ACS) is associated with an increased risk of developing atrial fibrillation (AF). This arrhythmia is associated with adverse outcomes, making it important to identify high-risk patients. The aim was to evaluate the prognostic value of measures of left atrial (LA) structure and function in AF prediction following ACS. Methods: Three hundred and eighty-one patients who had a percutaneous coronary intervention for ACS were included in the study. Our endpoint was new-onset AF. Results: With a median follow-up time of 5.4 [3.9–6.8] years, 56 patients (14.7%) developed AF. Patients developing AF had significantly (p ≤ 0.05) increased maximal and minimal LA volumes (LAV max and LAV min , respectively). LAV max and LAV min remained significantly increased in AF patients when indexing to either body surface area (LAV max /BSA and LAV min /BSA, respectively), left ventricle length in end diastole (LAV max /LVLd and LAV min /LVLd, respectively), or late mitral annular diastolic velocity (LAV max /a’ and LAV min /a’, respectively), while LA expansion index (LAEi), LA emptying fraction (LAEF), and peak LA longitudinal strain (PALS) were decreased. In univariable Cox regressions, all LA measures were found to be predictors of AF. After multivariable adjustment for clinical and echocardiographic parameters, all measures reflecting atrial function (LAV min , LAV min /BSA, LAV min /LVLd, LAV min /a’, LAV max /a’, LAEF, LAEi, and PALS) (p ≤ 0.05) but no structural measures (LAV max, LAV max /BSA, and LAV max /LVLd) remained significant independent predictors of AF. Conclusion: Echocardiographic measures of LA function are independent predictors of AF following ACS. Evaluation of LA function might improve the prognostic workup, aid in risk stratification for AF, and improve selection for further examinations.