CMR-derived left atrial reservoir strain was an independent predictor of major adverse cardiovascular events after STEMI (HR 0.905; 95% CI 0.843–0.972; P=0.006).
Cohort (n=202)
Does CMR derived left atrial strain predict major adverse cardiovascular events in patients after STEMI?
CMR-derived left atrial reservoir strain is an independent predictor of MACE after STEMI, providing incremental prognostic value over LVEF.
Effect estimate: HR 0.905 (95% CI 0.843-0.972)
p-value: p=0.006
Background: The prognostic value of cardiac magnetic resonance (CMR) derived left atrial (LA) strain, ejection fraction (LAEF) and indexed volumes (LAVImax and LAVImin) after ST-elevation myocardial infarction (STEMI) remains controversial. The aim of this study was to assess the relationship between LA function and major adverse cardiovascular events (MACE) after STEMI.Methods: A total of 202 prospectively recruited patients who underwent CMR at median day 4 after STEMI had complete CMR data for feature tracking assessment. LA reservoir and booster strain were quantified based on the average of three independently repeated measurements.Results: MACE occurred in 35 patients during a median follow up of 607 days. Patients with MACE had lower median LA reservoir strain (18.9% vs. 29.4%, P<0.001), LA booster strain (9.4% vs. 13.0%, P=0.002) and LAEF (41.5% vs. 49.2%, P<0.001) than patients without MACE. Kaplan-Meier analyses demonstrated a difference in MACE between high- and low-risk groups for LA reservoir strain (cutoff 19.2%, P<0.001), LA booster strain (cutoff 9.7%, P<0.001) and LAEF (cutoff 38.5%, P<0.001). The AUC increased from 0.713 (95% CI: 0.608–0.818) for LVEF to 0.775 (95% CI: 0.680–0.870) when LA reservoir strain was added to LVEF (P=0.047). Univariate Cox regression analysis showed that all LA parameters had a significant effect on MACE, while multivariate analysis found LA reservoir strain was an independent predictor of MACE (HR 0.905; 95% CI: 0.843–0.972, P=0.006).Conclusions: CMR derived LA reservoir strain independently predicted MACE after STEMI when adjusted for standard risk measures.
Nayyar et al. (Thu,) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=202). CMR derived left atrial (LA) reservoir strain was evaluated on Major adverse cardiovascular events (MACE) (HR 0.905, 95% CI 0.843-0.972, p=0.006). CMR-derived left atrial reservoir strain was an independent predictor of major adverse cardiovascular events after STEMI (HR 0.905; 95% CI 0.843–0.972; P=0.006).