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.
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.
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Authors: Ditte-Marie Bretler; Peter Riis Hansen; Jesper Lindhardsen; Ole Ahlehoff; Charlotte Andersson; Thomas Bo Jensen; Jakob Raunsø; Christian Torp-Pedersen; Gunnar Hilmar Gislason Journal: PLoS One Date: 2012-12-17 Impact factor: 3.240