Author + information
- Jakob Ledwoch,
- Thomas Stiermeier,
- Georg Fuernau,
- Suzanne de Waha,
- Charlotte Eitel,
- Janine Poess,
- Steffen Desch,
- Gerhard Schuler,
- Holger Thiele and
- Ingo Eitel
Background: Increasing evidence exists regarding the prognostic value of left atrial (LA) volumes and function in the setting of acute myocardial infarction. However, the exact relationship of LA function with markers of myocardial damage and reperfusion injury assessed by cardiac magnetic resonance (CMR) is unknown.
Methods: A total of 684 patients with STEMI reperfused by primary angioplasty were enrolled in this CMR study at 8 centers. A blinded central CMR core laboratory assessed LA volumes and function as well as classical markers of myocardial damage. The primary endpoint was the composite of all-cause mortality, recurrent AMI or new congestive heart failure (MACE) at 1 year.
Results: The median LA ejection fraction (LA-EF) was 53% (interquartile range 46% – 59%). Patients with impaired LA-EF (≤53%) had a significantly higher rate of MACE at 1 year (Figure). LA-EF correlated with left ventricular EF (r=0.40; p<0.001) and inversely correlated with infarct size (r=-0.35; p<0.001). LA-EF was found to be an independent predictor for MACE (hazard ratio 0.96 [95% confidence interval 0.94-0.98]). However, using c-statistics LA-EF showed no additional prognostic value over and above left ventricular EF in predicting MACE or its individual components.
Conclusions: Impaired LA-EF is a frequent finding in acute reperfused STEMI patients and is associated with large infarcts, impaired LVEF and subsequently poor prognosis.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Non Invasive Imaging: MR Characterization and Function
Abstract Category: 29. Non Invasive Imaging: MR
Presentation Number: 1118-213
- 2017 American College of Cardiology Foundation