급성 심근경색증 환자에서 예후 예측인자로서 좌심방 용적지수
Left Atrial Volume is a Predictor of Major Adverse Cardiac Events in Patients with Acute Myocardial Infarction
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Background/Aims:Diastolic dysfunction may develop in conjunction with or without systolic dysfunction in patients with acute myocardial infarction (AMI). The present study investigated the association between left arterial (LA) volume and major adverse cardiac events (MACE) in 772 patients with AMI. Methods:The patients were divided into groups according to LA volume index (LAVI) measured using echocardiography according to the American Society of Echocardiography guidelines: LAVI ≥ 40 mL/m2 (Group I: n = 260, 191 males; age, 71.1 ± 10.8 years) and LAVI < 40 mL/m2 (Group II: n = 512, 432 males; age, 62.8 ± 12.7 years). The mean observational period was 314.2 ± 134.6 days. Results:Group I patients were older than those in Group II. Hypertension (56.8% vs. 46.0%, respectively; p = 0.007) and advanced Killip class (42.6% vs. 21.0%, respectively; p < 0.001) were more frequent in Group I than in Group II. MACE was more prevalent in Group I than in Group II (20.3% vs. 13.7%, respectively; p = 0.037). MACE-free survival rates were higher in Group II than in Group I during clinical follow-up. The multivariate analysis revealed that high LAVI was an independent predictor of mortality (hazard ratio, 3.002; confidedce interval, 1.051-8.569; p = 0.040). Conclusions:LA volume is an independent predictor of adverse cardiac events in patients with AMI, and the LAVI is useful for AMI risk stratification.
Abstract
Background/Aims:Diastolic dysfunction may develop in conjunction with or without systolic dysfunction in patients with acute myocardial infarction (AMI). The present study investigated the association between left arterial (LA) volume and major adverse cardiac events (MACE) in 772 patients with AMI. Methods:The patients were divided into groups according to LA volume index (LAVI) measured using echocardiography according to the American Society of Echocardiography guidelines: LAVI ≥ 40 mL/m2 (Group I: n = 260, 191 males; age, 71.1 ± 10.8 years) and LAVI < 40 mL/m2 (Group II: n = 512, 432 males; age, 62.8 ± 12.7 years). The mean observational period was 314.2 ± 134.6 days. Results:Group I patients were older than those in Group II. Hypertension (56.8% vs. 46.0%, respectively; p = 0.007) and advanced Killip class (42.6% vs. 21.0%, respectively; p < 0.001) were more frequent in Group I than in Group II. MACE was more prevalent in Group I than in Group II (20.3% vs. 13.7%, respectively; p = 0.037). MACE-free survival rates were higher in Group II than in Group I during clinical follow-up. The multivariate analysis revealed that high LAVI was an independent predictor of mortality (hazard ratio, 3.002; confidedce interval, 1.051-8.569; p = 0.040). Conclusions:LA volume is an independent predictor of adverse cardiac events in patients with AMI, and the LAVI is useful for AMI risk stratification.
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