Prognostication and risk stratification by assessment of left atrioventricular plane displacement in patients with myocardial infarction.

• BACKGROUND: Mean left atrioventricular plane displacement is strongly related to prognosis in patients with heart failure. We aimed to examine its value for prognostication and risk stratification in patients hospitalised for acute myocardial infarction. METHODS AND RESULTS: Left atrioventricular plane displacement was assessed by echocardiography in 271 consecutive patients with acute myocardial infarction. Mean prospective follow-up was 628 days. Atrioventricular plane displacement was readily assessed in all patients and was significantly lower in patients who died (n=41, 15.1%) compared to the survivors: 8.2(5.6) v. 10.0(5.5) mm, P<0.0001. Overall mortality was 31.3% in the lowest quartile with regard to atrioventricular plane displacement (<8.00 mm) and 10.1% in the combined upper three quartiles. Thus, the hazard ratio for an atrioventricular plane displacement <8.0 mm compared to 8 mm or more was 3.1, P=0.0001. The combined mortality/heart failure hospitalisation incidence was 43.8% in the lowest and 14.6% in the combined upper three quartiles: Risk ratio 3.0, P<0.0001. In multivariate analysis, including age and history of atrial fibrillation, left atrioventricular plane displacement was an independent prognostic marker. CONCLUSION: In post-myocardial infarction patients, echocardiographic assessment of atrioventricular plane displacement showed a strong, independent prognostic value. Determination of left atrioventricular plane displacement can be readily performed in virtually all patients, and may in clinical practice facilitate identification of high-risk patients.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Heart Atrium : ultrasonography

Heart Failure

Congestive : complications

Congestive : mortality

Heart Ventricle : pathology

Heart Ventricle : ultrasonography

Hospital Mortality

Human

Morbidity

Middle Age

Male

Myocardial Infarction : complications

Myocardial Infarction : diagnosis

Myocardial Infarction : mortality

Prevalence

Prognosis

Risk Assessment

Survival Analysis

Sweden : epidemiology

Heart Atrium : pathology

Female

Follow-Up Studies

Echocardiography

Comparative Study

80 and over

Aged

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)