Left Atrial Remodeling in Acute Anterior Myocardial Infarction

Abstract

An increase in the diameter, volume, and dimensions of LA during atrial remodeling was detected. LA passive emptying fraction was found to decrease, whereas atrial active emptying function was found to increase to compensate for this change.

Relationship of ischemic times and left atrial volume and function in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

“…Our findings are also in line with study by Bozkurt et al [4] where echocardiography was performed on admission and after a week, 1 and 3 months, showing that LA volume increased significantly starting from hospital admission. The compensatory mechanism of stroke volume increase responded to volume change, but the difference became significant after a period of 1 month [4]. Left atrial remodeling, defined as increase in LA volume of 8 ml/m 2 has been shown to occur in about one fifth of patients after AMI leading to LA functional deterioration over a 12-month period [5].…”

“…This mechanism is functional up to certain LA volumes when increased volume load cannot be further compensated by increased work and LA further dilates, indicating that Frank-Starling mechanism is also operative in the LA [28]. Our findings are also in line with study by Bozkurt et al [4] where echocardiography was performed on admission and after a week, 1 and 3 months, showing that LA volume increased significantly starting from hospital admission. The compensatory mechanism of stroke volume increase responded to volume change, but the difference became significant after a period of 1 month [4].…”

“…Diastolic dysfunction in the setting of acute myocardial infarction (AMI) arises from profound regional asynchrony between ischemic and normal myocardium resulting in disturbed ventricular relaxation and elevated myocardial stiffness [3]. Several studies have demonstrated that LA undergoes significant remodelling following AMI due to increased left ventricular end-diastolic pressure (LVEDP) [4][5][6] and it has also been shown that LA volume is an important predictor of morbidity and mortality after AMI [7,8]. On the other hand, the relationship of duration of ischemia and LA volumes during acute phase of myocardial infarction has not been previously investigated.…”

The effects of spironolactone on atrial remodeling in patients with preserved left ventricular function after an acute myocardial infarction

“…The means of the LAEF in this study were consistent with the LAEF values of this study. Bozkurt et al [31] studied LA remodeling in 65 AMI patients who were treated with conventional therapy, and they did not find a significant change in the LAEF during the 3-month follow-up. Similarly, our study did not show any change in the LAEF of conventional therapy group.…”

Favourable effects of exercise-based Cardiac Rehabilitation after acute myocardial infarction on left atrial remodeling

“…Left atrium (LA) enlargement, as determined by echocardiography, is an important predictor of cardiovascular outcome [1][2][3][4]. LA enlargement is associated with a poor exercise tolerance [5], and is predictive of future stroke, atrial fibrillation, and death [4,6].…”