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


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.


CONCLUSIONS
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.
Brand
Björn
B
Department of Cardiology, Malmö University Hospital, Lund University, S-205 02, Sweden.
Rydberg
Erik
E
Ericsson
Gerd
G
Gudmundsson
Petri
P
Willenheimer
Ronnie
R
D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology*; D006333:Heart Failure / Q000150:complications / Q000401:mortality; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology