Left atrial volume: A powerful predictor of survival after acute myocardial infarction

Møller, Jacob Eifer; Hillis, Graham S.; Pellikka, Patricia A.; Seward, James B.; Reeder, Guy S.; Wright, R. Scott; Park, Seung W.; Oh, Jae K.

doi:10.1016/s0735-1097(03)81307-4

Cited by 156 publications

(245 citation statements)

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“…35 However, because LA afterload, a key modulator of LA size, is based on LV chamber compliance, as well as LV volume, LA diameter reduction may also reflect improved LV compliance and/or relaxation as a consequence of reduction in LV hypertrophy. 36 The present study also adds to previous knowledge by demonstrating that the favorable initial reduction in LA diameter induced by antihypertensive therapy diminishes over time, in spite of persistent reduction in blood pressure and LV hypertrophy, particularly in the atenolol group. This phenomenon, which emerged after 3 to 4 years of study therapy, may be related to the continuous aging of the study population and increased prevalence of mitral regurgitation, as well as occurrences of myocardial infarctions and other CV events during the study period.…”

Section: Discussionsupporting

confidence: 76%

Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment

et al. 2007

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Abstract-The influence of left atrial size on cardiovascular events during antihypertensive treatment has not been reported previously from a long-term, prospective, randomized hypertension treatment trial. We recorded left atrial diameter by annual echocardiography and cardiovascular events in 881 hypertensive patients (41% women) with electrocardiographic left ventricular hypertrophy aged 55 to 80 (mean: 66) years during a mean of 4. S tudies in samples of the general population and in hypertensive patients have identified left atrial (LA) enlargement as a cardiovascular (CV) risk marker, in particular for atrial fibrillation and stroke. [1][2][3] We have shown previously that larger LA diameter in hypertensive patients is associated with other clinical and echocardiographic covariates of higher CV risk in hypertension, including higher body mass index, systolic blood pressure and age, left ventricular (LV) hypertrophy, eccentric LV geometry and mitral regurgitation by echocardiography, and atrial fibrillation. 4 However, less is known about the effect of antihypertensive treatment on LA diameter or on the relation between LA diameter and CV events during antihypertensive treatment. 5 Therefore, we evaluated the effect of losartan-or atenolol-based antihypertensive therapy on LA diameter and the relation between in-treatment LA diameter and CV events in the echocardiographic substudy of the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study. Methods Patient PopulationThe LIFE echocardiography study was a prospectively planned substudy of the main LIFE study, which enrolled 960 of the 9193 participants in the parent trial for annual echocardiographic follow-up. 6,7 Patient characteristics and outcome results in the main LIFE study that randomly assigned patients aged 55 to 80 years with essential hypertension (baseline blood pressure: 160 to 200/95 to 115 mm Hg) and ECG LV hypertrophy (according to Cornell voltage duration or Sokolow-Lyon voltage criteria) to a mean of 4.8 years double-blind treatment with losartan compared with atenolol have been published, including the effects of treatment on CV events and regression of ECG LV hypertrophy. 6,8 Of the 960 patients enrolled in the LIFE echocardiographic substudy, 881 patients had LA diameter measured at enrollment and on Ն1 follow-up echocardiogram and, thus, were eligible for the present study (Table 1). Patients were classified as having isolated systolic hypertension if systolic blood pressure was Ն140 mm Hg and diastolic blood pressure Ͻ90 mm Hg, respectively, at baseline clinic visits. 9 Pulse pressure was calculated as the

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Section: Discussionsupporting

confidence: 76%

Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment

et al. 2007

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“…[311][312][313][314][315][316] In the absence of MVD, an increase in LA size most commonly reflects increased wall tension as a result of increased LA pressure, [317][318][319][320] as well as impairment in LA function secondary to atrial myopathy. 321,322 A clear relationship exists between an enlarged LA and the incidence of atrial fibrillation and stroke, [323][324][325][326][327][328][329][330][331][332] risk for overall mortality after myocardial infarction, 321,322,333,334 risk for death and hospitalization in patients with dilated cardiomyopathy, [335][336][337][338][339][340][341][342][343][344] and major cardiac events or death in patients with diabetes mellitus. 345 left atrium enlargement is a marker of both the severity and chronicity of diastolic dysfunction and magnitude of LA pressure elevation.…”

Section: Imaging Techniques To Detect Atrial Cardiomyopathies Mappingmentioning

confidence: 99%

“…347 For assessment of atrial size, most widely reported is the linear dimension in the parasternal long-axis view using M-mode or 2 delayed enhancement (DE). [324][325][326][327][328][329][330][331][332][333][334][335][336][337][338][339]345,[347][348][349] However, due to the complex 3D nature of the atrium and the non-uniform nature of atrial remodelling, this measurement frequently does not provide an accurate picture of LA size. 350 -354 Thus, when assessing LA size and remodelling, the measurement of LA volume is a more powerful prognostic indicator in a variety of cardiac disease states.…”

Section: Echocardiographymentioning

confidence: 99%

“…350 -354 Thus, when assessing LA size and remodelling, the measurement of LA volume is a more powerful prognostic indicator in a variety of cardiac disease states. 329,331,[333][334][335][336][337][338][339]345,[347][348][349][350][351][352][353][354][355][356][357][358][359][360] Two-dimensional echocardiographic LA volumes are typically smaller than those reported from computed tomography or cardiac magnetic resonance imaging (CMR). [361][362][363][364][365] Left atrium volume from 2D images is best measured using the disk summation algorithm because it includes fewer geometric assumptions.…”

Section: Echocardiographymentioning

confidence: 99%

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EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

et al. 2016

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“…The size of the left atrium is an important determinant of prognosis (20)(21)(22) and predicts the likelihood of AF recurrence after restoration to normal sinus rhythm (23). It is unclear if LAMAX is a more important predictor of prognosis and response to therapy than traditional measures of left atrial size.…”

Section: Other Clinical Implicationsmentioning

confidence: 99%

Cardiac cycle–dependent left atrial dynamics: Implications for catheter ablation of atrial fibrillation

et al. 2008

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Left atrial volume: A powerful predictor of survival after acute myocardial infarction

Cited by 156 publications

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Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment

Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment

EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication

Cardiac cycle–dependent left atrial dynamics: Implications for catheter ablation of atrial fibrillation

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