Abstract
Purpose: Left atrial (LA) volume index (LAVI) has been reported to reflect left ventricular (LV) diastolic dysfunction and predict cardiac events in patients with coronary artery disease (CAD). Late diastolic mitral annular velocity (A’) has been shown to correlate well with LA function and LV filling pressure. We hypothesized that A’ could be a useful predictor of mortality and rehospitalization due to heart failure (HF) in CAD patients with dilated LA volume. Subjects and Methods: This study included 212 patients (mean age: 64 years, 166 men) who were admitted to the coronary care unit at our hospital due to acute coronary syndrome (ACS). They underwent echocardiography including tissue Doppler imaging (TDI). None of them had atrial fibrillation and atrial flutter or more than moderate mitral valvular disease. The primary study endpoints were mortality and rehospitalization due to HF. Results and Discussion: During a mean follow-up of 508 days, eight patients died and nine patients were rehospitalized due to HF. According to a previous report, the patients were divided into two groups. Group A: LAVI≥32 ml/m2 (n=62) and Group B: LAVI⟨32 ml/m2 (n=150). Receiver operator curve analysis revealed that A’≥10.7 cm/s was the optimal cut-off value to predict mortality and rehospitalization due to HF in Group A. In Group A, patients with A’≥10.7 cm/sec showed a significantly lower incidence of cardiac events than those with A’⟨10.7 cm/sec (log-rank, p=0.0019). However, A’ could not be a predictor of events in Group B. Conclusion: A’ could be a useful predictor of mortality and rehospitalization due to HF in ACS patients with large LAVI.
