title: Incidence, determinants and consequences of left atrial remodelling after a first anterior myocardial infarction.
abstract: BACKGROUND
  Left atrial (LA) volume is an important predictor of mortality and morbidity after myocardial infarction (MI). However, the process of LA remodelling has not been extensively investigated.
  
  
  OBJECTIVE
  Our purpose was to analyse the incidence, determinants and consequences of LA remodelling in a cohort of patients with a first anterior MI enrolled in the modern era of MI management.
  
  
  METHODS
  We used data from 246 patients with a first anterior MI who were included in a prospective study on left ventricular (LV) remodelling (REVE-2). Serial echocardiographic studies were performed before discharge and at 3 months and 1 year after MI.
  
  
  RESULTS
  LA volume increased from 20.5±5.9 mL/m2 at baseline to 24.6±7.4 mL/m2 at 3 months (P<0.0001 versus baseline) and 25.4±7.6 mL/m2 at 1 year (P<0.0001 versus baseline). Patients with high LA volumes at baseline had higher LV volumes, decreased LV systolic function, increased E/Ea (early transmitral velocity/mitral annular early diastolic velocity ratio) and increased B-type natriuretic peptide concentration. By multivariable analysis, the sole independent predictor of change in LA volume from baseline to 1 year was peak creatine kinase concentration (P<0.0001). Patients with higher LA volumes at baseline were at higher risk of cardiovascular death or rehospitalization for heart failure during follow-up (P=0.015).
  
  
  CONCLUSIONS
  Despite modern therapeutic management, LA remodelling is common during the first 3 months after anterior MI. Patients with larger infarct size are at greater risk of LA remodelling after discharge.
authors.affiliation: Hôpital cardiologique, CHRU de Lille, Inserm U744, Institut Pasteur de Lille, université de Lille-2, 51019 Lille, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.forename: Marie
authors.initials: M
authors.lastname: Fertin
authors.forename: Pascal
authors.initials: P
authors.lastname: de Groote
authors.forename: Christophe
authors.initials: C
authors.lastname: Bauters
mesh_terms: D016280:Atrial Function, Right; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005602:France / Q000453:epidemiology; D006325:Heart Atria / Q000503:physiopathology*; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging; D011379:Prognosis