Correlation between left vetricle and left atrium echocardiographic parameters in long term follow up after acute myocardial infarction

Introduction: Dimensions and function of left atrium are a good predictor for supraventricular arrhythmias. Pacients suffering from myocardial infarction can de-velop worsening of the heart failure if any arrhythmia occurs. Correlating the 2D and 3D echocardiography images of left ventricle and left atrium in pacients after an acute myocardial infarction can lead to discovering early supraventricular arrhythmias predictors.

Objective: We aim to correlate left ventricular and cli-nical/angiographic characteristics to left atrium para-meters using new echocardiographic techniques (3D, strain, dispersion) in pacients with myocardial infarc-tion in order to obtain early predictors for supraventri-cular arrhythmias.

Methods: We included 25 patients (mean age of 63.7 years) presenting with acute ST elevation myocardial infarction that underwent percutaneous intervention with/without stent angioplasty. Patients having severe associated pathologies were excluded. We assessed the group using clinical examination, 2D and 3D echo-cardiography at baseline and at follow up (between 3 and 8 years). We assessed the evolution in time of va-rious echocardiographic parameters at T0–days after the acute coronary event and T1–3 to 8 years after the myocardial infarction. Then, we correlated the trend of these parameters over time with major cardiovascular factor risks and with angiographic characteristics (time to revascularization, number of lesions, the severity of the stenosis or TIMI flow at the end of the procedure). Results: All patients recorded a very good correlation between the left atrium parametres measured by 3D and 2D echocardiography (volumes, PALS, PACS, EF, strain, dispersion) with p<0.05. This could suggest that, in need, a quick echocardiography with only represen-tative parameters can be used in the examination of left atrium without trading the specificity of the method. We found a statistically significant, directly proporti-onal relation when comparing the LA volumes to te-lediastolic LV volumes and also LVEF (p<0.05). We demonstrated a link between LVEF and LAEF as well (p=0.003). The left atrium volumes directly correlated to the number of coronary lesions (p=0.042) and also to the grade of the stenosis (p=0.012), pointing out that the severity of the coronary lesions directly links to the risk of supraventricular arrhythmias. Age is also a de-terminant factor for left atrium function (p<0.05).

Conclusions: We concluded that there is a strong rela-tionship between left ventricle echocardiographic para-meters (especially the telediastolic volume and LVEF) and left atrium characteristics. This idea could later be used in developing new instruments for predicting su-praventricular arrhythmias with less and less resources.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)