Left atrial adaptation in ischemic heart disease: insights from a cardiovascular magnetic resonance study.

Details

Serval ID
serval:BIB_B8793EB2AF0A
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Left atrial adaptation in ischemic heart disease: insights from a cardiovascular magnetic resonance study.
Journal
The international journal of cardiovascular imaging
Author(s)
Pavon A.G., Masci P.G., Pucci L., Landi A., Bermano A., Vaxman A., Gotsman C., Rutz T., Monney P., Godihno R., Saraiva Rodrigues D., Muller O., Valgimigli M., Schwitter J.
ISSN
1875-8312 (Electronic)
ISSN-L
1569-5794
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Left atrium (LA) plays a key role in the overall cardiac performance. However, it remains unclear how LA adapts, in terms of function and volumes, to left ventricular dysfunction in the acute and post-acute phases of myocardial infarction. LA volumes and function were evaluated in patients in the acute phase of ST-segment elevation myocardial infarction (acute-STEMI group) and in the post-acute phase after STEMI (post-acute STEMI group). Ten age and sex-matched healthy controls served as control group. In all subjects LA was assessed by a compressed-sensing cine pulse sequence and by a 3D non-model-based reconstruction. LV infarct size and microvascular obstruction were determined on late-gadolinium-enhancement data and LV myocardial oedema and myocardial haemorrhage were measured on T <sub>2</sub> -mapping data. Indexed LA maximum and minimum volumes did not differ between the acute (n = 50) and post-acute (n = 47) STEMI groups. LA active emptying fraction (LA <sub>AEF</sub> ) was higher in the acute-STEMI as compared with the post-acute STEMI groups (0.63 ± 0.23 vs 0.37 ± 0.24, p < 0.0001). Conversely, LA passive emptying fraction (LA <sub>PEF</sub> ) was lower in the acute-STEMI compared with post-acute-STEMI (0.34 ± 0.15 vs 0.65 ± 0.15, p < 0.0001) patients. In the acute-STEMI group, LA <sub>AEF</sub> was positively and LA <sub>PEF</sub> negatively correlated with LV myocardial tissue damage (r = 0.523 p = 0.0001; r = - 0.451 p = 0.0013). Negative and positive correlations were also found between LA <sub>AEF</sub> and LA <sub>PEF</sub> and time after STEMI (r = - 0.559 p = 0.0013 and r = 0.589 p = 0.0006, respectively). LA increases its active contractile function in the acute phase of STEMI to support LV filling. The extent (but not the type) of LV damage determines LA adaptions which normalizes over time.
Keywords
Cardiovascular magnetic resonance, Left atrium, Left atrium function, ST-segment elevation myocardial infarction
Pubmed
Web of science
Create date
01/03/2022 12:42
Last modification date
03/09/2022 6:39
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