title: Progressive dilation of the left atrium and ventricle after acute myocardial infarction is associated with high mortality.
abstract: OBJECTIVE
  The purpose of this study is to identify the prevalence of progressive dilation in patients with acute myocardial infarction (AMI) combined with heart failure (HF) and determine the prognostic significance and associated factors with a geometric change of an infarcted heart.
  
  
  METHODS
  A total of 1310 AMI patients with HF (63.9±12.5 years, 70% male) between November 2005 and April 2011 underwent echocardiography at admission and one year later. Left ventricular (LV) remodeling is defined as 20% progression, and left atria (LA) remodeling is 10% compared with the initial volume index.
  
  
  RESULTS
  The prevalence of both LA and LV remodeling was 13.9%; LV only was 9.3%, LA only 22.8% and non-remodeling was 55.1%, respectively. In the non-remodeling group, Killip class II was more frequent (83.9%, p<0.001) whereas in other remodeling groups, Killip class III was more frequent. Initial wall motion score index, ejection fraction, maximal cardiac enzyme, high sensitive C-reactive protein, B type natriuretic peptide, and triglyceride serum levels were significantly associated with heart remodeling. All causes of death occurred in 168 cases (12.8%) during the follow-up period. Mortality was the highest in the LV and LA remodeling group (20.9%) and the lowest in the non-remodeling group (11.4%). During the period of follow-up, the cumulative survival rate was significantly lower in the groups of LA and LV remodeling than in others (log rank p=0.006).
  
  
  CONCLUSIONS
  Total mortality was significantly increased in patients AMI with geometrically progressive LA and LV dilatation.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Yuna
authors.initials: Y
authors.lastname: Jeong
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Song
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Su Young
authors.initials: SY
authors.lastname: Jang
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Keun Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.affiliation: The Heart Center of Chonnam National University Hospital, Korea Cardiovascular Stent Research Institute of Chonnam National University, Gwangju, Korea.
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
keywords: Heart failure; Myocardial infarction; Prognosis; Ventricular remodeling