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

Research output: Contribution to journalArticle

Abstract

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.

Details

Authors
  • Björn Brand
  • Erik Rydberg
  • Gerd Ericsson
  • Petri Gudmundsson
  • Ronnie Willenheimer
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • 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
Original languageEnglish
Pages (from-to)35-41
JournalInternational Journal of Cardiology
Volume83
Issue number1
Publication statusPublished - 2002
Publication categoryResearch
Peer-reviewedYes