Maximum left atrial (LA) volume is associated with diastolic properties of the left ventricle and has recently been shown to predict cardiovascular events in a wide spectrum of people.^1–3 In contrast to Doppler variables of left ventricular (LV) diastolic function, which are affected by acute haemodynamic changes, maximum LA volume is more stable, integrating the effects of increased LV filling pressures from pre-existing cardiovascular conditions. Minimum LA volume, however, is influenced by both pre-existing conditions leading to increased LV filling pressures and acute haemodynamic changes that affect LA contraction. We sought to assess the independent predictive power of maximum and minimum LA volumes for the development of congestive heart failure (CHF) or death within 30 days after myocardial infarction (MI).

METHODS

Of 456 consecutive patients with acute MI admitted to our centres during 1996, 12 died shortly after admission. Echocardiographic evaluation was not possible within 48 hours because of logistic limitations in 22 patients and because of inadequate imaging in 23. On admission CHF was diagnosed in 70 patients (Killip class ⩾ II or atrial fibrillation). The remaining 324 patients (65 women, mean age of 60 (12) years) constituted the study population. Relevant clinical data were prospectively collected from all patients.

All patients underwent a complete echocardiographic examination. LV volumes were measured with the biplane modified Simpson’s algorithm. Doppler assessment was in …