Diastolic dysfunction predicts new-onset atrial fibrillation and cardiovascular events in patients with acute myocardial infarction and depressed left ventricular systolic function: a CARISMA substudy.

Abstract

AIMS:

The aim of this study was to investigate the association between diastolic dysfunction and long-term occurrence of new-onset atrial fibrillation (AF) and cardiac events in patients with acute myocardial infarction (AMI) and left ventricular (LV) systolic dysfunction.

METHODS AND RESULTS:

The study was performed as a substudy on the CARISMA study population. The CARISMA study enrolled 312 patients with an AMI and LV ejection fraction <or=40%. Patients were implanted with an implantable loop recorder and followed for 2 years. Sixty-two patients had a full echocardiographic assessment of the diastolic function using tissue Doppler analysis performed 6 weeks after the AMI. The endpoints were: (i) new-onset AF and (ii) major cardiovascular events (MACE) defined as re-infarction, stroke, or cardiovascular death. Twenty-four patients had diastolic dysfunction, whereas 38 patients had normal diastolic function. Diastolic dysfunction was associated with an increased risk of new-onset AF [HR = 5.30 (1.68-16.75), P = 0.005] and MACE [HR = 4.70 (1.25-17.75), P = 0.022] after adjustment for age, sex, NYHA class, and hypertension.

CONCLUSION:

Diastolic dysfunction in post-MI patients with LV systolic dysfunction predisposes to new-onset AF and MACE.

• Authors: Christian Jons, Rikke Moerch Joergensen, Christian Hassager, Uffe J Gang, Ulrik Dixen, Arne Johannesen, Niels Thue Olsen, Thomas F Hansen, Marc Messier, Heikki V Huikuri, Poul Erik Bloch Thomsen
• Journal: European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology (Eur J Echocardiogr) Vol. 11 Issue 7 Pg. 602-7 (Aug 2010) ISSN: 1532-2114 [Electronic] England
• PMID: 20304839 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Topics

• Aged
• Atrial Fibrillation (diagnosis, etiology, physiopathology, prevention & control)
• Denmark
• Diastole
• Echocardiography, Doppler
• Electrocardiography, Ambulatory
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Myocardial Infarction (complications)
• Predictive Value of Tests
• Prognosis
• Risk Assessment
• Sampling Studies
• Secondary Prevention
• Sensitivity and Specificity
• Time Factors
• Ventricular Dysfunction, Left