Article Text

Download PDFPDF
Original article
Left atrial strain is related to adverse events in patients after acute myocardial infarction treated with primary percutaneous coronary intervention
  1. M Louisa Antoni,
  2. Ellen A ten Brinke,
  3. Jael Z Atary,
  4. Nina Ajmone Marsan,
  5. Eduard R Holman,
  6. Martin J Schalij,
  7. Jeroen J Bax,
  8. Victoria Delgado
  1. Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Victoria Delgado, Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands; v.delgado{at}


Background Left atrial (LA) maximal volume is of prognostic value in patients after acute myocardial infarction (AMI). Recently, LA mechanical function and LA strain have been introduced as alternative methods to assess LA performance more accurately.

Objective To evaluate the relation between LA volume, mechanical function and strain, and adverse events in patients after AMI.

Methods Patients with AMI underwent two-dimensional echocardiography within 48 h of admission. LA volume and LA performance (mechanical function and systolic strain) were quantified. The endpoint was a composite of all-cause mortality, reinfarction and hospitalisation for heart failure.

Results 320 patients (mean age 60±12 years, 78% men) were followed up for 27±14 months. During follow-up, 48 patients (15%) reached the composite endpoint. After adjustment for clinical and echocardiographic parameters, LA maximal volume (HR 1.05, CI 1.00 to 1.10, p=0.04) and LA strain (HR 0.94, CI 0.89 to 0.99, p=0.02) were independently associated with adverse outcome. In addition, LA strain provided incremental value to LA maximal volume (p=0.03) for the prediction of adverse outcome.

Conclusions After AMI treated with primary percutaneous coronary intervention, LA strain provides additional prognostic value beyond LA maximal volume.

  • Echocardiography
  • left atrium
  • myocardial infarction
  • prognosis
  • cardiac remodelling
  • diastolic dysfunction
  • risk stratification
  • stemi

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding JJB received grants from GE Healthcare, Lantheus Medical Imaging, St Jude Medical, Medtronic, Boston Scientific, Biotronik and Edwards Lifesciences. MJS received grants from Boston Scientific, Medtronic and Biotronik.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.