Early changes in left atrial volume after acute myocardial infarction: Relation to invasive hemodynamics at rest and during exercise

R. Bakkestrom, Mads J Andersen, M. Ersboll, John Bro-Jeppesen, F Gustafsson, L. Kober, C. Hassager, J. E. Moller

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise. The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22 patients (35%)). Patients with LA remodeling were characterized by lower a' (1 month 8.9 +/- 2.0 vs. 10.4 +/- 2.5 cm/s, p = 0.002; 4 month 8.8 +/- 2.0 vs. 10.4 +/- 2.4 cm/s, p = 0.007) and higher MR-proANP (1 month 162 +/- 64 vs. 120 +/- 44 pg/l, p = 0.005; 4 months 175 +/- 48 vs. 129 +/- 56 pg/l, p = 0.002). With exercise, pulmonary artery pressure, right atrial pressure and pulmonary capillary wedge pressure increased markedly in all patients. There were however, no significant differences in filling pressure at rest or during exercise irrespective of whether LA remodeling occurred. Conclusion: Contrary to our hypothesis early LA dilatation after MI was weakly associated with resting and exercise induced changes in LA pressure overload. The dilatation was however associated with lower e' and higher MR-proANP. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
Original languageEnglish
JournalInternational Journal of Cardiology
Volume223
Pages (from-to)717-722
ISSN0167-5273
DOIs
Publication statusPublished - 2016

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Heart Atria
Exercise
Dilatation
Atrial Pressure
Natriuretic Peptides
Pulmonary Wedge Pressure
Exercise Test
Pulmonary Artery
Heart Ventricles
Echocardiography

Bibliographical note

ISI Document Delivery No.: EB0LV Times Cited: 0 Cited Reference Count: 29 Bakkestrom, Rine Andersen, Mads J. Ersboll, Mads Bro-Jeppesen, John Gustafsson, Finn Kober, Lars Hassager, Christian Moller, Jacob E. Bakkestrom, Rine/0000-0002-1182-8458 Danish Council for Independent Research, Copenhagen; Danish Heart Foundation, Copenhagen; Toyota Foundation, Copenhagen; Arvid Nielsens Foundation, Copenhagen; A and E Danielsens Foundation, Copenhagen; Lauritz Peter and Wife Foundation, Hillerod; Brd. Hartmann Foundation, Herlufmagle; Capital Region, Copenhagen; Lykfeldts Foundation, Hedehusene; S Jacobsen and Wife Foundation, Copenhagen; Karl G Andersen Foundation, Copenhagen The study was supported by grants from the following Danish Foundations: The Danish Council for Independent Research, Copenhagen; the Danish Heart Foundation, Copenhagen; Toyota Foundation, Copenhagen; Arvid Nielsens Foundation, Copenhagen; A and E Danielsens Foundation, Copenhagen; Lauritz Peter and Wife Foundation, Hillerod; Brd. Hartmann Foundation, Herlufmagle; the Capital Region, Copenhagen; Lykfeldts Foundation, Hedehusene; S Jacobsen and Wife Foundation, Copenhagen and; Karl G Andersen Foundation, Copenhagen. 0 2 Elsevier ireland ltd Clare 1874-1754

Keywords

  • Acute myocardial infarction Diastolic dysfunction echocardiography Remodeling Left atrial volume index Hemodynamic stress proatrial natriuretic peptide left-ventricular dysfunction preserved ejection fraction chronic heart-failure size echocardiography prediction biomarkers mortality survival Cardiovascular System & Cardiology

Cite this

Bakkestrom, R. ; Andersen, Mads J ; Ersboll, M. ; Bro-Jeppesen, John ; Gustafsson, F ; Kober, L. ; Hassager, C. ; Moller, J. E. / Early changes in left atrial volume after acute myocardial infarction : Relation to invasive hemodynamics at rest and during exercise. In: International Journal of Cardiology. 2016 ; Vol. 223. pp. 717-722.
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title = "Early changes in left atrial volume after acute myocardial infarction: Relation to invasive hemodynamics at rest and during exercise",
abstract = "Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise. The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45{\%}, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22 patients (35{\%})). Patients with LA remodeling were characterized by lower a' (1 month 8.9 +/- 2.0 vs. 10.4 +/- 2.5 cm/s, p = 0.002; 4 month 8.8 +/- 2.0 vs. 10.4 +/- 2.4 cm/s, p = 0.007) and higher MR-proANP (1 month 162 +/- 64 vs. 120 +/- 44 pg/l, p = 0.005; 4 months 175 +/- 48 vs. 129 +/- 56 pg/l, p = 0.002). With exercise, pulmonary artery pressure, right atrial pressure and pulmonary capillary wedge pressure increased markedly in all patients. There were however, no significant differences in filling pressure at rest or during exercise irrespective of whether LA remodeling occurred. Conclusion: Contrary to our hypothesis early LA dilatation after MI was weakly associated with resting and exercise induced changes in LA pressure overload. The dilatation was however associated with lower e' and higher MR-proANP. (C) 2016 Elsevier Ireland Ltd. All rights reserved.",
keywords = "Acute myocardial infarction Diastolic dysfunction echocardiography Remodeling Left atrial volume index Hemodynamic stress proatrial natriuretic peptide left-ventricular dysfunction preserved ejection fraction chronic heart-failure size echocardiography prediction biomarkers mortality survival Cardiovascular System & Cardiology",
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Early changes in left atrial volume after acute myocardial infarction : Relation to invasive hemodynamics at rest and during exercise. / Bakkestrom, R.; Andersen, Mads J; Ersboll, M.; Bro-Jeppesen, John; Gustafsson, F; Kober, L.; Hassager, C.; Moller, J. E.

In: International Journal of Cardiology, Vol. 223, 2016, p. 717-722.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Early changes in left atrial volume after acute myocardial infarction

T2 - Relation to invasive hemodynamics at rest and during exercise

AU - Bakkestrom, R.

AU - Andersen, Mads J

AU - Ersboll, M.

AU - Bro-Jeppesen, John

AU - Gustafsson, F

AU - Kober, L.

AU - Hassager, C.

AU - Moller, J. E.

N1 - ISI Document Delivery No.: EB0LV Times Cited: 0 Cited Reference Count: 29 Bakkestrom, Rine Andersen, Mads J. Ersboll, Mads Bro-Jeppesen, John Gustafsson, Finn Kober, Lars Hassager, Christian Moller, Jacob E. Bakkestrom, Rine/0000-0002-1182-8458 Danish Council for Independent Research, Copenhagen; Danish Heart Foundation, Copenhagen; Toyota Foundation, Copenhagen; Arvid Nielsens Foundation, Copenhagen; A and E Danielsens Foundation, Copenhagen; Lauritz Peter and Wife Foundation, Hillerod; Brd. Hartmann Foundation, Herlufmagle; Capital Region, Copenhagen; Lykfeldts Foundation, Hedehusene; S Jacobsen and Wife Foundation, Copenhagen; Karl G Andersen Foundation, Copenhagen The study was supported by grants from the following Danish Foundations: The Danish Council for Independent Research, Copenhagen; the Danish Heart Foundation, Copenhagen; Toyota Foundation, Copenhagen; Arvid Nielsens Foundation, Copenhagen; A and E Danielsens Foundation, Copenhagen; Lauritz Peter and Wife Foundation, Hillerod; Brd. Hartmann Foundation, Herlufmagle; the Capital Region, Copenhagen; Lykfeldts Foundation, Hedehusene; S Jacobsen and Wife Foundation, Copenhagen and; Karl G Andersen Foundation, Copenhagen. 0 2 Elsevier ireland ltd Clare 1874-1754

PY - 2016

Y1 - 2016

N2 - Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise. The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22 patients (35%)). Patients with LA remodeling were characterized by lower a' (1 month 8.9 +/- 2.0 vs. 10.4 +/- 2.5 cm/s, p = 0.002; 4 month 8.8 +/- 2.0 vs. 10.4 +/- 2.4 cm/s, p = 0.007) and higher MR-proANP (1 month 162 +/- 64 vs. 120 +/- 44 pg/l, p = 0.005; 4 months 175 +/- 48 vs. 129 +/- 56 pg/l, p = 0.002). With exercise, pulmonary artery pressure, right atrial pressure and pulmonary capillary wedge pressure increased markedly in all patients. There were however, no significant differences in filling pressure at rest or during exercise irrespective of whether LA remodeling occurred. Conclusion: Contrary to our hypothesis early LA dilatation after MI was weakly associated with resting and exercise induced changes in LA pressure overload. The dilatation was however associated with lower e' and higher MR-proANP. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

AB - Background: Dilatation of left atrium (LA) reflects chronic LA pressure or volume overload that possesses considerable prognostic information. Little is known regarding the interaction between LA remodeling after acute myocardial infarction (MI) and left atrial pressure at rest and during exercise. The objective was to assess changes in LA volume early after MI in patients with diastolic dysfunction and the relation to invasive hemodynamics and natriuretic peptides. Methods: 62 patients with left ventricle ejection fraction (LVEF) >= 45%, diastolic E/e' > 8 and LA volume index >34 ml/m(2) within 48 h of MI were enrolled. After 1 and 4 months blood sampling, echocardiography and right heart catheterization were performed during exercise test. Results: LA remodeling was considered in patients with a change from mild (35-41 ml/m(2)), to severe (>48ml/m(2)) dilatation after 4 months (Found in 22 patients (35%)). Patients with LA remodeling were characterized by lower a' (1 month 8.9 +/- 2.0 vs. 10.4 +/- 2.5 cm/s, p = 0.002; 4 month 8.8 +/- 2.0 vs. 10.4 +/- 2.4 cm/s, p = 0.007) and higher MR-proANP (1 month 162 +/- 64 vs. 120 +/- 44 pg/l, p = 0.005; 4 months 175 +/- 48 vs. 129 +/- 56 pg/l, p = 0.002). With exercise, pulmonary artery pressure, right atrial pressure and pulmonary capillary wedge pressure increased markedly in all patients. There were however, no significant differences in filling pressure at rest or during exercise irrespective of whether LA remodeling occurred. Conclusion: Contrary to our hypothesis early LA dilatation after MI was weakly associated with resting and exercise induced changes in LA pressure overload. The dilatation was however associated with lower e' and higher MR-proANP. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

KW - Acute myocardial infarction Diastolic dysfunction echocardiography Remodeling Left atrial volume index Hemodynamic stress proatrial natriuretic peptide left-ventricular dysfunction preserved ejection fraction chronic heart-failure size echocardiography pr

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DO - 10.1016/j.ijcard.2016.08.228

M3 - Journal article

C2 - 27573595

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JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

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