Portal de Periódicos da CAPES

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

2010; Oxford University Press; Volume: 11; Issue: 7 Linguagem: Inglês

10.1093/ejechocard/jeq024

1525-2167

Christian Jøns, Rikke Moerch Joergensen, Christian Hassager, Uffe Jakob Ortved Gang, Ulrik Dixen, A. Johannesen, Niels Thue Olsen, Thomas Hansen, Marc Messier, Heikki V. Huikuri, Poul Erik Bloch Thomsen,

Atrial Fibrillation Management and Outcomes

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