Left atrial strain is related to adverse events in patients after acute myocardial infarction treated with primary percutaneous coronary intervention.

BACKGROUND: Left atrial (LA) maximal volume is of prognostic value in patients after acute myocardial infarction (AMI). Recently, LA mechanical function and LA strain have been introduced as alternative methods to assess LA performance more accurately.

OBJECTIVE: To evaluate the relation between LA volume, mechanical function and strain, and adverse events in patients after AMI.

METHODS: Patients with AMI underwent two-dimensional echocardiography within 48 h of admission. LA volume and LA performance (mechanical function and systolic strain) were quantified. The endpoint was a composite of all-cause mortality, reinfarction and hospitalisation for heart failure.

RESULTS: 320 patients (mean age 60±12 years, 78% men) were followed up for 27±14 months. During follow-up, 48 patients (15%) reached the composite endpoint. After adjustment for clinical and echocardiographic parameters, LA maximal volume (HR 1.05, CI 1.00 to 1.10, p=0.04) and LA strain (HR 0.94, CI 0.89 to 0.99, p=0.02) were independently associated with adverse outcome. In addition, LA strain provided incremental value to LA maximal volume (p=0.03) for the prediction of adverse outcome.

CONCLUSIONS: After AMI treated with primary percutaneous coronary intervention, LA strain provides additional prognostic value beyond LA maximal volume.