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Prognostication and risk stratification by assessment of left atrioventricular plane displacement in patients with myocardial infarction.

Brand, Björn LU ; Rydberg, Erik LU ; Ericsson, Gerd; Gudmundsson, Petri and Willenheimer, Ronnie LU (2002) In International Journal of Cardiology 83(1). p.35-41
Abstract
BACKGROUND: Mean left atrioventricular plane displacement is strongly related to prognosis in patients with heart failure. We aimed to examine its value for prognostication and risk stratification in patients hospitalised for acute myocardial infarction. METHODS AND RESULTS: Left atrioventricular plane displacement was assessed by echocardiography in 271 consecutive patients with acute myocardial infarction. Mean prospective follow-up was 628 days. Atrioventricular plane displacement was readily assessed in all patients and was significantly lower in patients who died (n=41, 15.1%) compared to the survivors: 8.2(5.6) v. 10.0(5.5) mm, P<0.0001. Overall mortality was 31.3% in the lowest quartile with regard to atrioventricular plane... (More)
BACKGROUND: Mean left atrioventricular plane displacement is strongly related to prognosis in patients with heart failure. We aimed to examine its value for prognostication and risk stratification in patients hospitalised for acute myocardial infarction. METHODS AND RESULTS: Left atrioventricular plane displacement was assessed by echocardiography in 271 consecutive patients with acute myocardial infarction. Mean prospective follow-up was 628 days. Atrioventricular plane displacement was readily assessed in all patients and was significantly lower in patients who died (n=41, 15.1%) compared to the survivors: 8.2(5.6) v. 10.0(5.5) mm, P<0.0001. Overall mortality was 31.3% in the lowest quartile with regard to atrioventricular plane displacement (<8.00 mm) and 10.1% in the combined upper three quartiles. Thus, the hazard ratio for an atrioventricular plane displacement <8.0 mm compared to 8 mm or more was 3.1, P=0.0001. The combined mortality/heart failure hospitalisation incidence was 43.8% in the lowest and 14.6% in the combined upper three quartiles: Risk ratio 3.0, P<0.0001. In multivariate analysis, including age and history of atrial fibrillation, left atrioventricular plane displacement was an independent prognostic marker. CONCLUSION: In post-myocardial infarction patients, echocardiographic assessment of atrioventricular plane displacement showed a strong, independent prognostic value. Determination of left atrioventricular plane displacement can be readily performed in virtually all patients, and may in clinical practice facilitate identification of high-risk patients. (Less)
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published
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keywords
Heart Atrium : ultrasonography, Heart Failure, Congestive : complications, Congestive : mortality, Heart Ventricle : pathology, Heart Ventricle : ultrasonography, Hospital Mortality, Human, Morbidity, Middle Age, Male, Myocardial Infarction : complications, Myocardial Infarction : diagnosis, Myocardial Infarction : mortality, Prevalence, Prognosis, Risk Assessment, Survival Analysis, Sweden : epidemiology, Heart Atrium : pathology, Female, Follow-Up Studies, Echocardiography, Comparative Study, 80 and over, Aged
in
International Journal of Cardiology
volume
83
issue
1
pages
35 - 41
publisher
Elsevier
external identifiers
  • pmid:11959382
  • wos:000175320400007
  • scopus:0036226529
ISSN
0167-5273
DOI
10.1016/S0167-5273(02)00007-4
language
English
LU publication?
yes
id
16621ee5-fb1b-419c-a295-c27e531b4763 (old id 107716)
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http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11959382&dopt=Abstract
date added to LUP
2007-07-02 10:34:44
date last changed
2017-08-06 03:47:11
@article{16621ee5-fb1b-419c-a295-c27e531b4763,
  abstract     = {BACKGROUND: Mean left atrioventricular plane displacement is strongly related to prognosis in patients with heart failure. We aimed to examine its value for prognostication and risk stratification in patients hospitalised for acute myocardial infarction. METHODS AND RESULTS: Left atrioventricular plane displacement was assessed by echocardiography in 271 consecutive patients with acute myocardial infarction. Mean prospective follow-up was 628 days. Atrioventricular plane displacement was readily assessed in all patients and was significantly lower in patients who died (n=41, 15.1%) compared to the survivors: 8.2(5.6) v. 10.0(5.5) mm, P&lt;0.0001. Overall mortality was 31.3% in the lowest quartile with regard to atrioventricular plane displacement (&lt;8.00 mm) and 10.1% in the combined upper three quartiles. Thus, the hazard ratio for an atrioventricular plane displacement &lt;8.0 mm compared to 8 mm or more was 3.1, P=0.0001. The combined mortality/heart failure hospitalisation incidence was 43.8% in the lowest and 14.6% in the combined upper three quartiles: Risk ratio 3.0, P&lt;0.0001. In multivariate analysis, including age and history of atrial fibrillation, left atrioventricular plane displacement was an independent prognostic marker. CONCLUSION: In post-myocardial infarction patients, echocardiographic assessment of atrioventricular plane displacement showed a strong, independent prognostic value. Determination of left atrioventricular plane displacement can be readily performed in virtually all patients, and may in clinical practice facilitate identification of high-risk patients.},
  author       = {Brand, Björn and Rydberg, Erik and Ericsson, Gerd and Gudmundsson, Petri and Willenheimer, Ronnie},
  issn         = {0167-5273},
  keyword      = {Heart Atrium : ultrasonography,Heart Failure,Congestive : complications,Congestive : mortality,Heart Ventricle : pathology,Heart Ventricle : ultrasonography,Hospital Mortality,Human,Morbidity,Middle Age,Male,Myocardial Infarction : complications,Myocardial Infarction : diagnosis,Myocardial Infarction : mortality,Prevalence,Prognosis,Risk Assessment,Survival Analysis,Sweden : epidemiology,Heart Atrium : pathology,Female,Follow-Up Studies,Echocardiography,Comparative Study,80 and over,Aged},
  language     = {eng},
  number       = {1},
  pages        = {35--41},
  publisher    = {Elsevier},
  series       = {International Journal of Cardiology},
  title        = {Prognostication and risk stratification by assessment of left atrioventricular plane displacement in patients with myocardial infarction.},
  url          = {http://dx.doi.org/10.1016/S0167-5273(02)00007-4},
  volume       = {83},
  year         = {2002},
}