title: Predictors and prognostic value of left atrial remodelling after acute myocardial infarction.
abstract: Left atrial (LA) volume is a strong prognostic predictor in patients following ST-segment elevation myocardial infarction (STEMI). However, the change in LA volume over time (LA remodelling) following STEMI has been scarcely studied. We sought to identify predictors for LA remodelling and to evaluate the prognostic importance of LA remodelling.
  
  
  
  This is a subgroup analysis from a randomised clinical trial that evaluated the cardioprotective effect of exenatide treatment. A total of 160 patients with STEMI underwent a cardiovascular MR (CMR) 2 days after primary angioplasty and a second scan 3 months later. LA remodelling was defined as changes in LA volume or function from baseline to 3 months follow-up. Major adverse cardiac events were registered after a median of 5.2 years.
  
  
  
  Adverse LA minimum volume (LAmin) remodelling was correlated to the presence of hypertension, larger infarct size by CMR, higher peak troponin T, larger area at risk and adverse left ventricular (LV) remodelling. LA maximum volume (LAmax) remodelling was correlated to larger infarct size by CMR, higher peak troponin T, larger area at risk, larger LV mass, impaired LV function and adverse LV remodelling. Kaplan-Meier and Log Rank analyses showed that patients in the highest tertiles of LAmin or LAmax remodelling are at higher risk (0.030 and p=0.018).
  
  
  
  After a myocardial infarction, LA remodelling reflects a parallel ventricular-atrial remodelling. Infarct size is a major determinant of LA remodelling following STEMI and adverse LA remodelling is associated with an unfavourable prognosis.
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark ; Department of Biomedical Sciences , Copenhagen University , Copenhagen , Denmark.
authors.forename: Kasper
authors.initials: K
authors.lastname: Kyhl
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Vejlstrup
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Lønborg
authors.affiliation: Department of Biomedical Sciences , Copenhagen University , Copenhagen , Denmark.
authors.forename: Marek
authors.initials: M
authors.lastname: Treiman
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Kiril Aleksov
authors.initials: KA
authors.lastname: Ahtarovski
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Holmvang
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Helle
authors.initials: H
authors.lastname: Søholm
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Mads J
authors.initials: MJ
authors.lastname: Andersen
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Møller
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
authors.affiliation: Department of Cardiology , Rigshospitalet , Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
keywords: HEART FAILURE; STEMI < MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)