Left atrial strain is associated with long-term mortality in acute coronary syndrome patients

The International Journal of Cardiovascular Imaging - Trang 1-11 - 2024
Philip Rüssell Pedersson1,2, Kristoffer Grundtvig Skaarup1,2, Mats Christian Højbjerg Lassen1,2, Flemming Javier Olsen1,2, Allan Zeeberg Iversen1, Peter Godsk Jørgensen1, Tor Biering-Sørensen1,2
1Department of Cardiology, Copenhagen University Hospital—Herlev & Gentofte, Copenhagen, Denmark
2Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Tóm tắt

To investigate the long-term prognostic value of the left atrial (LA) strain indices – peak atrial longitudinal strain (PALS), peak conduit strain (PCS), and peak atrial contractile strain (PACS) in acute coronary syndrome (ACS) patients in relation to all-cause mortality. This retrospective study included ACS patients treated with percutaneous coronary intervention (PCI) and examined with echocardiography. Exclusion criteria were non-sinus rhythm during echocardiography, missing images, and inadequate image quality for 2D speckle tracking analysis of the LA. The endpoint was all-cause death. Multivariable Cox regression which included relevant clinical and echocardiographic measures was utilized to assess the relationship between LA strain parameters and all-cause mortality. A total of 371 were included. Mean age was 64 years and 76% were male. Median time to echocardiography was 2 days following PCI. During a median follow-up of 5.7 years, 83 (22.4%) patients died. Following multivariable analysis, PALS (HR 1.04, 1.01–1.06, p = 0.002, per 1% decrease) and PCS (HR 1.05, 1.01–1.09, p = 0.006, per 1% decrease) remained significantly associated with all-cause mortality. PALS and PCS showed a linear relationship with the outcome whereas PACS was associated with the outcome in a non-linear fashion such that the risk of death increased when PACS < 18.22%. All LA strain parameters remained associated with worse survival rate when restricting analysis to patients with left atrial volume index < 34 ml/m2. Reduced LA function as assessed by PALS, PCS, and PACS were associated with an increased risk of long-term mortality in patients with ACS.

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The International Journal of Cardiovascular Imaging

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