Assessment of Left Atrial Volume Index in the Patients with ACS in Adults
Keywords:
Acute Coronary Syndrome, Diabetes Mellitus, Left Atrial Volume IndexAbstract
Background: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death universally. The present study was conducted to assess LA volume index (LAVI) in the patients with ACS in adults. Subjects and Methods: The present study was conducted on120 adult patients diagnosed with ACS of both genders in narayana medical college hospital from May 2016 toOctober 2016. Patients were divided into 2 groups of 60 each. Group I patients had LAVI > 34 ml/m2and group II patients had LAVI ≤ 34 ml/m2. The LV systolic function was analyzed by Simpson’s disc volumetric method. The LAV was assessed by the biplane area-length method from apical 4-chamber and 2-chamber views. Results: The mean BMI in group I patients was 26.7 kg/m2and in group II was 26.1 kg/m2, AW STEMI in group I was seen in 30 patients and in group II in 32, IW + PW STEMI in 6 and 4 patients in both groups respectively, IW STEMI in 5 and 4 patients respectively, NSTEMI in 4 and 3 patients respectively and UA in 15 and 17 patients respectively. Risk factors were diabetes mellitus in 32 and 27 patients respectively, hypertension in 41 and 40 patients respectively, smoking in 43 and 38 patients respectively, alcohol in 30 and 35 patients respectively and positive family history in 12 and 16 patients respectively. The difference was non- significant (P> 0.05). The mean LAVI at admission in group I was 38.1 and in group II was 27.2, after 1 month was 40.2 and 28.1 in both groups, after 6 months was 39.1 and 27.9 in both groups and after 12 months was 42.7 and 25.3 in both groups respectively. The difference was significant (P<0.05). Conclusion: Authors conclude that LAVI was found to be the independent predictor of mortality than left ventricular ejection fraction on multivariate regression analysis. Common risk factors in patients with ACS were diabetes mellitus, hypertension, smoking, alcoholism and positive family history. Patients with LAVI of value >34 ml/m2 were associated with increased comorbidities.
Downloads
References
1. O’gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, Lemos JAD. ACCF/AHA guideline for the management of ST elevation myocardial infarction: A report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;127:362–425. Available from: https://dx.doi.org/10. 1161/cir.0b013e3182742cf6.
2. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60:1581–98.
3. Nagueh SF, Appleton CP, Gillebert TC, Marino PN, Oh JK, Smiseth OA, et al. Recommendations for the Evaluation of Left Ventricular Diastolic Function by Echocardiography. J Am Soc Echocardiogr. 2009;22(2):107–133. Available from: https://dx.doi.org/10.1016/j.echo.2008.11.023.
4. Lang RM, Badano LP, Moravi V, Afilalo J, Armstrong A, Ernande L. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39. Available from: https://dx.doi. org/10.1016/j.echo.2014.10.003.
5. Ristow B, Ali S, Whooley MA, Schiller NB. Usefulness of Left Atrial Volume Index to Predict Heart Failure Hospi talization and Mortality in Ambulatory Patients With Coro nary Heart Disease and Comparison to Left Ventricular Ejec tion Fraction (from the Heart and Soul Study). Am J Car diol. 2008;102(1):70–76. Available from: https://dx.doi.org/10. 1016/j.amjcard.2008.02.099.
6. Simek CL, Feldman MD, Haber HL, Wu CC, Jayaweera AR, Kaul S. Relationship between left ventricular wall thickness
and left atrial size: Comparison with other measures of diastolic function. J Am Soc Echocardiogr. 1995;8(1):37–47. Available from: https://dx.doi.org/10.1016/s0894-7317(05)80356-6.
7. Møller JE, Søndergaard E, Poulsen SH, Egstrup K. Pseudonor mal and restrictive filling patterns predict left ventricular dila tion and cardiac death after a first myocardial infarction: a serial color M-mode doppler echocardiographic study. J Am Coll Cardiol. 2000;36(6):1841–1846. Available from: https: //dx.doi.org/10.1016/s0735-1097(00)00965-7.
8. Kou S, Caballero L, Dulgheru R, Voilliot D, Sousa CD, Kacharava G, et al. Echocardiographic reference ranges for normal cardiac chamber size: results from the NORRE study. Eur Heart J Cardiovasc Imaging. 2014;15(6):680–690. Available from: https://dx.doi.org/10.1093/ehjci/jet284.
9. Nagula P, Yerrabandi SRV, Otikunta AN, Karumuri S. A clinical study of prognostic significance of left atrial volume index in patients with acute coronary syndrome. J Ind Coll Cardiol. 2019;9(4):186–186. Available from: https://dx.doi. org/10.4103/jicc.jicc_39_19.
10. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60:1581–98.
11. Gunasekaran R, Maskon O, Hassan HHC, Safian N, Sak thiswary R. Left Atrial Volume Index Is an Independent Pre dictor of Major Adverse Cardiovascular Events in Acute Coro nary Syndrome. Can J Cardiol. 2012;28(5):561–566. Available from: https://dx.doi.org/10.1016/j.cjca.2012.02.015.
12. Poulsen MK, Dahl JS, Henriksen JE, Hey TM, Høilundcarlsen PF, Nielsen B, et al. Left atrial volume index: Relation to long term clinical outcome in type 2 diabetes. J Am Coll Cardiol. 2013;62:2416–2437.
