TEMPORAL CHANGES IN LEFT ATRIAL FUNCTION AND LEFT ATRIOVENTRICULAR COUPLING ASSESSED BY 2D SPECKLE-TRACKING AND 3D ECHOCARDIOGRAPHY FOLLOWING PERCUTANEOUS CORONARY INTERVENTION IN ACUTE MYOCARDIAL INFARCTION

Abstract

Objectives: To assess temporal changes in left atrial (LA) function and left atrioventricular coupling (LAC) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) using advanced echocardiographic techniques. Methods: A prospective, descriptive, longitudinal, controlled study was conducted on 120 patients with AMI undergoing PCI and 50 control subjects without coronary artery disease, matched for age, sex, and cardiovascular risk factors. Echocardiography was performed to assess LA strain and left atrioventricular coupling index (LACI) in both groups, with the AMI group undergoing assessment at baseline (within 24 hours of admission), 7 days, 1 month, 3 months, 6 months, 9 months, and 12 months post-PCI. Results: Compared with controls, AMI patients showed impaired LA function, including lower LAEF (54.6% ​​vs. 64.4%), LASr (28.9% vs. 44.3%), LAScd (14.2% vs. 21.9%), LASct (14.9% vs. 22.3%), all p < 0.001, while LACI was higher (19.2% vs. 15.1%; p < 0.001). Following PCI, LACI improved by 7 days (19.2% vs. 17.6%; p = 0.027), LAEF improved by 1 month (58.5% vs. 54.6%; p = 0.001), and LA strain improved by 3 months: LASr (38.7% vs. 28.9%), LAScd (17.9% vs. 14.2%), and LASct (20.8% vs. 14.9%), all p < 0.001. These trends continued up to 12 months post-PCI, with ongoing improvements in LACI (p = 0.006), LAEF (p = 0.003), and LA strain (p < 0.001). Conclusion: Patients with AMI had impaired LA function and LAC, which gradually improved following PCI. Serial assessment of LA strain and LACI provides valuable insight into cardiac recovery and risk stratification after AMI.