Key result
MI size >15% links to worse LA remodeling and dysfunction, regardless of infarct location.
Why the study?
The size and location of myocardial infarction cause adverse left ventricular remodeling, but their effect on the left atrium remains unclear.
Does the location and size of previous myocardial infarction affect left atrial function as measured by CMR-FT?
Observational (n=129)
Does the location and size of previous myocardial infarction affect left atrial function as measured by CMR-FT?
p-value: p=<0.05
Myocardial infarct size, rather than location, is the primary determinant of post-infarction left atrial remodeling and dysfunction as assessed by CMR-FT.
Background: LA function has been recognized as a significant prognostic marker in many cardiovascular diseases. Cardiovascular magnetic resonance feature tracking (CMR-FT) represents a promising technique for left atrial function evaluation. The size and location of myocardial infarction are important factors in the cause of adverse left ventricular remodeling, but the effect on the left atriam is unclear. Purpose: to investigate the effect of location and size of previous myocardial infarction (MI) on LA function using CMR-FT. Study type: retrospective. Population: patients formerly diagnosed with anterior MI (n = 42) or non-anterior MI (n = 40) and healthy controls (n = 47). Field Strength/Sequence: a 3.0T MR, Steady state free precession (SSFP), Phase-sensitive inversion recovery (PSIR). Assessment: infarct location and size were assigned and quantified by late-gadolinium enhancement (LGE) imaging. LA performance was analyzed using CMR-FT in 2- and 4-chamber cine images, including LA reservoir, conduit and booster pump function. Statistics: descriptive statistics, ANOVA with post Bonferroni correction, Kruskal−Wallis H, Spearman’s correlation, intraclass correlation coefficient. Results: Anterior MI patients had impaired LA reservoir function (LATEF, εs, SRs), conduit function (LAPEF, εe, SRs) and booster pump function (LAAEF, εa) compared with controls (p < 0.05). Non-anterior MI patients had impaired LA strain (εs, εe, εa; p < 0.05) but preserved LAEFs (p > 0.05). After adjusting the area of MI, there was no significant difference in the LA morphology and function between the anterior and non-anterior wall groups. Stratification analysis by MI size revealed that LA volumes and LAEFs were unchanged in patients with MI size ≤ 15% compared with controls (p > 0.05); only εs and εe were decreased (p < 0.05). Increased LAVIpre-a, LAVImin and decreased LATEF, and LAAEF were found in patients with MI size > 15% compared with the MI size ≤ 15% group (p < 0.05). LVSVI, εs and MI size were significant correlated with LAVI pre-a in multiple stepwise regression analysis. Data conclusions: The location of myocardial infarction is not a major factor affecting the morphology and function of the left atrium. Patients with MI size > 15% experience more pronounced post-infarction LA remodeling and dysfunction than MI size ≤ 15% patients.
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Zhang et al. (2022) conducted an observational in Myocardial infarction (n=129). Myocardial infarction (anterior vs non-anterior, and size >15% vs ≤15%) vs. Healthy controls and between MI groups was evaluated on Left atrial function (reservoir, conduit, and booster pump function) evaluated by CMR-FT (p=<0.05). Myocardial infarction size >15% caused more pronounced post-infarction left atrial remodeling and dysfunction than MI size ≤15% (p<0.05), whereas MI location had no significant effect.
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