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Aronson D, Sliman H, Abadi S, Maiorov I, Perlow D, Mutlak D, Lessick J. Conduit Flow Compensates for Impaired Left Atrial Passive and Booster Functions in Advanced Diastolic Dysfunction. Circ Cardiovasc Imaging 2024; 17:e016276. [PMID: 38716653 PMCID: PMC11111319 DOI: 10.1161/circimaging.123.016276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/14/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND Quantification of left atrial (LA) conduit function and its contribution to left ventricular (LV) filling is challenging because it requires simultaneous measurements of both LA and LV volumes. The functional relationship between LA conduit function and the severity of diastolic dysfunction remains controversial. We studied the role of LA conduit function in maintaining LV filling in advanced diastolic dysfunction. METHODS We performed volumetric and flow analyses of LA function across the spectrum of LV diastolic dysfunction, derived from a set of consecutive patients undergoing multiphasic cardiac computed tomography scanning (n=489). From LA and LV time-volume curves, we calculated 3 volumetric components: (1) early passive emptying volume; (2) late active (booster) volume; and (3) conduit volume. Results were prospectively validated on a group of patients with severe aortic stenosis (n=110). RESULTS The early passive filling progressively decreased with worsening diastolic function (P<0.001). The atrial booster contribution to stroke volume modestly increases with impaired relaxation (P=0.021) and declines with more advanced diastolic function (P<0.001), thus failing to compensate for the reduction in early filling. The conduit volume increased progressively (P<0.001), accounting for 75% of stroke volume (interquartile range, 63-81%) with a restrictive filling pattern, compensating for the reduction in both early and booster functions. Similar results were obtained in patients with severe aortic stenosis. The pulmonary artery systolic pressure increased in a near-linear fashion when the conduit contribution to stroke volume increased above 60%. Maximal conduit flow rate strongly correlated with mitral E-wave velocity (r=0.71; P<0.0001), indicating that the increase in mitral E wave in diastolic dysfunction represents the increased conduit flow. CONCLUSIONS An increase in conduit volume contribution to stroke volume represents a compensatory mechanism to maintain LV filling in advanced diastolic dysfunction. The increase in conduit volume despite increasing LV diastolic pressures is accomplished by an increase in pulmonary venous pressure.
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Affiliation(s)
- Doron Aronson
- Departments of Cardiology (D.A., H.S., D.P., D.M., J.L.), Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine (D.A., S.A., D.M., J.L.), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Hend Sliman
- Departments of Cardiology (D.A., H.S., D.P., D.M., J.L.), Rambam Health Care Campus, Haifa, Israel
| | - Sobhi Abadi
- Medical Imaging (S.A.), Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine (D.A., S.A., D.M., J.L.), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ida Maiorov
- BioMedical Engineering (I.M.), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Daniel Perlow
- Departments of Cardiology (D.A., H.S., D.P., D.M., J.L.), Rambam Health Care Campus, Haifa, Israel
| | - Diab Mutlak
- Departments of Cardiology (D.A., H.S., D.P., D.M., J.L.), Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine (D.A., S.A., D.M., J.L.), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Jonathan Lessick
- Departments of Cardiology (D.A., H.S., D.P., D.M., J.L.), Rambam Health Care Campus, Haifa, Israel
- Faculty of Medicine (D.A., S.A., D.M., J.L.), Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Comparison Between Echocardiography and Cardiac Computed Tomography in the Evaluation of Diastolic Dysfunction and Prediction of Heart Failure. Am J Cardiol 2022; 181:71-78. [PMID: 35963824 DOI: 10.1016/j.amjcard.2022.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/30/2022] [Accepted: 07/05/2022] [Indexed: 11/21/2022]
Abstract
Recent data indicate that left atrial (LA) function assessment by cardiac computed tomography (CT) is closely related to diastolic dysfunction (DD). Therefore, we aimed to perform a direct comparison between CT and echocardiography for diagnosis of advanced DD and prediction of future heart failure or cardiovascular death. We identified 340 patients who had both spiral cardiac CT and a proximate echocardiogram. LA total emptying fraction (LATEF), a measure of global LA function, was automatically calculated from CT data, as a surrogate for diastolic function and was compared with echocardiographic grades of diastolic function. The area under the receiver operating characteristic curve for LATEF to differentiate between advanced DD (grades 2 and 3) and all other grades was 0.84 (0.79 to 0.88). Over a median of 4 years, 69 events (admissions for heart failure and cardiovascular deaths) occurred. By multivariate Cox analysis, LATEF <40% provided incremental prognostic information after adjustments for advanced DD by echocardiography (hazard ratio 2.15, 95% confidence interval 1.13 to 3.94). There was a significant interaction (p = 0.03) between LATEF and echocardiography-based diastolic grades. Stratified analyses within the diastolic function groups revealed that LATEF <40% was equivalent to echocardiography in predicting events in the subgroup with advanced DD by echocardiography (p = 0.20) but was associated with a significantly higher event rates in patients with normal filling pressures (p = 0.0001) or indeterminate diastolic function (p = 0.04) by echocardiography. In conclusion, LA function derived from CT can accurately detect advanced DD diagnosed by echocardiography and has additive value to echocardiography-derived DD.
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Carpenito M, Fanti D, Mega S, Benfari G, Bono MC, Rossi A, Ribichini FL, Grigioni F. The Central Role of Left Atrium in Heart Failure. Front Cardiovasc Med 2021; 8:704762. [PMID: 34485406 PMCID: PMC8414134 DOI: 10.3389/fcvm.2021.704762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/19/2021] [Indexed: 12/28/2022] Open
Abstract
In past cardiovascular medicine, the attention to the left ventricle-identified as the only indicator and determinant of healthy or unhealthy cardiac conditions- has systematically hidden the role of the left atrium (LA). The recent advances in cardiovascular imaging have provided a better understanding of LA anatomy, physiology, and pathology, making us realize that this functional structure is far from being an innocent spectator. We now know that the LA's mechanical and neuro-hormonal properties play a relevant part in several cardiovascular diseases, including atrial fibrillation, ischemic heart disease, valvular heart disease, and heart failure. The present review aims to describe the role of LA in the specific setting of heart failure. We provide currently available information on LA structure and function and summarize its role as a determinant of symptoms, prognosis, and potential therapeutic target in heart failure patients.
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Affiliation(s)
- Myriam Carpenito
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Diego Fanti
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Simona Mega
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giovanni Benfari
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | - Maria Caterina Bono
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Andrea Rossi
- Section of Cardiology, Department of Medicine, University of Verona, Verona, Italy
| | | | - Francesco Grigioni
- Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
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Lessick J, Mutlak D, Mutlak M, Sheik-Muhamad R, Naami R, Efraim R, Abadi S, Aronson D. Left atrial function by cardiac computed tomography is a predictor of heart failure and cardiovascular death. Eur Radiol 2021; 32:132-142. [PMID: 34136947 DOI: 10.1007/s00330-021-08093-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/17/2021] [Accepted: 05/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We sought to evaluate cardiac CT angiography (CCTA)-based assessment of left atrial (LA) function as a predictor of hospitalizations for heart failure (HF) and cardiovascular (CV) mortality. METHODS LA function was evaluated using automatic derivation of LA volumes to calculate LA total emptying fraction (LATEF) in 788 consecutive patients with normal sinus rhythm who had undergone spiral CT scans. The relationship between LATEF evaluated by CCTA and the composite endpoint of admission for HF or CV mortality was analyzed using Cox models. RESULTS During a median follow-up of 4 years, there were 100 events, 62 HF hospitalizations, and 38 cardiovascular deaths. Mean LATEF was 30.7 ± 10.7% and 40.5 ± 11.2% in patients with and without events, respectively (p < 0.0001). A high LATEF (upper tertile > 46%) was associated with a very low event rate (3.5% at 6 years [95% CI 1.7-7.1%]). The adjusted HR for HF or CV mortality was 4.37 (95% CI 1.99-9.60) in the lowest LATEF tertile, and 2.29 (95% CI 1.03-5.14) in the middle tertile, relative to the highest tertile. For the endpoint of HF alone, adjusted HR for the lowest LATEF tertile was 5.93 (95% CI 2.23-15.82) and for the middle tertile 2.89 (95% CI 1.06-7.86). The association of LATEF with outcome was similar for patients with both reduced and preserved left ventricular (LV) ejection fraction (Pinteraction = 0.724). Reduced LATEF was associated with a high event rate, even when coupled with normal LA volume. CONCLUSION CCTA-derived LA function is a predictor of HF hospitalization or CV death, independent of clinical risk factors, LA volume, and LV systolic function. KEY POINTS • Left atrial function can be automatically derived from cardiac CTA scans. • Cardiac CTA-derived left atrial function is a predictor of hospitalization for heart failure and cardiovascular death. • Evaluation of left atrial function could be useful in identifying patients at risk of heart failure.
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Affiliation(s)
- Jonathan Lessick
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel.
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel.
| | - Diab Mutlak
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel
| | - Michael Mutlak
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel
| | - Rabia Sheik-Muhamad
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
| | - Robert Naami
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel
| | - Roi Efraim
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
| | - Sobhi Abadi
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel
- Medical Imaging Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
| | - Doron Aronson
- Cardiology Department, Rambam Health Care Campus, Haaliya Street, 31096, Haifa, Israel
- Technion-Israel Institute of Technology, Haaliya Street, 31096, Haifa, Israel
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Ben-Arzi A, Hazanov E, Ghanim D, Rozen G, Marai I, Grosman-Rimon L, Kachel E, Amir O, Carasso S. Left atrial minimal volume: association with diastolic dysfunction and heart failure in patients in sinus rhythm or atrial fibrillation with preserved ejection fraction. BMC Med Imaging 2021; 21:76. [PMID: 33957873 PMCID: PMC8101036 DOI: 10.1186/s12880-021-00606-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/21/2021] [Indexed: 01/28/2023] Open
Abstract
Background Evidence of diastolic dysfunction (DD) required for the diagnosis of heart failure with preserved ejection fraction (HFpEF) is elusive in atrial fibrillation (AF). Left ventricular (LV) and left atrial (LA) speckle-tracking echocardiography (STE) may provide rhythm independent indications of DD. We aimed to find common LV/LA myocardial mechanics parameters to demonstrate DD, using STE in patients with AF. Methods 176 echocardiographic assessments of patients were studied retrospectively by STE. 109 patients with history of AF were divided in three groups: sinus with normal diastolic function (n = 32, ND), sinus with DD (n = 35, DD) and patients with AF during echocardiography (n = 42). These assessments were compared to 67 normal controls. Demographic, clinical, echocardiographic and myocardial mechanic characteristics were obtained. Results The patients with DD in sinus rhythm and patients with AF were similar in age, mostly women, and had cardiovascular risk factors as well as higher dyspnea prevalence compared to either controls or patients with ND. In the AF group, LV ejection fraction (LVEF) (p = 0.008), global longitudinal strain and LA emptying were lower (p < 0.001), whereas LA volumes were larger (p < 0.001) compared to the other groups. In a multivariable analysis of patients in sinus rhythm, LA minimal volume indexed to body surface area (Vmin-I) was found to be the single significant factor associated with DD (AUC 83%). In all study patients, Vmin-I correlated with dyspnea (AUC 80%) and pulmonary hypertension (AUC 90%). Conclusions Vmin-I may be used to identify DD and assist in the diagnosis of HFpEF in patients with AF.
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Affiliation(s)
- Assaf Ben-Arzi
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | - Evgeni Hazanov
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel
| | - Diab Ghanim
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel
| | - Guy Rozen
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | - Ibrahim Marai
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | | | - Erez Kachel
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.,Department of Cardiothoracic Surgery, Leviev Heart Center, Sheba Medical Center, Tel HaShomer, Israel
| | - Offer Amir
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel.,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.,Department of Cardiology, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Shemy Carasso
- Cardiovascular Institute, Poriya Medical Center, Lower Galilee, Israel. .,The Azrieli Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel.
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Accuracy of Diastolic Function by Cardiac Computed Tomography Relative to Echo-Doppler: Additive Clinical and Prognostic Value. J Comput Assist Tomogr 2021; 45:242-247. [PMID: 33661156 DOI: 10.1097/rct.0000000000001136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES We aimed to assess the agreement between cardiac computed tomography (CT) and echo for diagnosing advanced diastolic dysfunction (DD) and to assess the prognostic value of CT-based parameters. METHODS One hundred one consecutive patients who had both CT and echo-Doppler within 1 month were included. Diastolic function was assessed by CT using a previously validated method, based on left atrial volume changes, and compared with echocardiography grades 0 to 3. Patients were followed up for a combined outcome of cardiac death and hospitalization for heart failure. RESULTS By operating characteristic curve analysis, the best CT-based parameter for predicting advanced DD based on echo was left atrial total emptying fraction. Left atrial total emptying fraction <36% had sensitivity/specificity of 76%/86%. Agreement between echo and CT for detecting advanced (grades 2/3) DD was substantial (κ = 0.62, P < 0.0001). By Cox multivariate analysis, left atrial total emptying fraction was a powerful independent predictor of outcome at 3 years (hazard ratio, 8.0 [2.2-28.4]; P < 0.0001). CONCLUSIONS Computed tomography-based assessment of DD has a good agreement with echo-Doppler-based results. Left atrial total emptying fraction seems to have a strong prognostic value.
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Marino PN, Degiovanni A, Zanaboni J. Complex interaction between the atrium and the ventricular filling process: the role of conduit. Open Heart 2019; 6:e001042. [PMID: 31673383 PMCID: PMC6802994 DOI: 10.1136/openhrt-2019-001042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 11/21/2022] Open
Affiliation(s)
- Paolo N Marino
- Department of Translational Medicine, Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, Italy
| | - Anna Degiovanni
- Cardiac-thoracic-vascular Department, Azienda Ospedaliero-Universitaria Maggiore della Carita, Novara, Italy
| | - Jacopo Zanaboni
- Department of Translational Medicine, Università degli Studi del Piemonte Orientale Amedeo Avogadro Scuola di Medicina, Novara, Italy
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Aziz W, Claridge S, Ntalas I, Gould J, de Vecchi A, Razeghi O, Toth D, Mountney P, Preston R, Rinaldi CA, Razavi R, Niederer S, Rajani R. Emerging role of cardiac computed tomography in heart failure. ESC Heart Fail 2019; 6:909-920. [PMID: 31400060 PMCID: PMC6816076 DOI: 10.1002/ehf2.12479] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 05/20/2019] [Accepted: 05/30/2019] [Indexed: 11/27/2022] Open
Abstract
Despite medical advancements, the prognosis of patients with heart failure remains poor. While echocardiography and cardiac magnetic resonance imaging remain at the forefront of diagnosing and monitoring patients with heart failure, cardiac computed tomography (CT) has largely been considered to have a limited role. With the advancements in scanner design, technology, and computer processing power, cardiac CT is now emerging as a valuable adjunct to clinicians managing patients with heart failure. In the current manuscript, we review the current applications of cardiac CT to patients with heart failure and also the emerging areas of research where its clinical utility is likely to extend into the realm of treatment, procedural planning, and advanced heart failure therapy implementation.
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Affiliation(s)
- Waqar Aziz
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Simon Claridge
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Ioannis Ntalas
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Justin Gould
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Adelaide de Vecchi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Orod Razeghi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Daniel Toth
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Peter Mountney
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Rebecca Preston
- Department of Radiology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Christopher A Rinaldi
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Reza Razavi
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Steven Niederer
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Ronak Rajani
- Department of Cardiology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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Degiovanni A, Boggio E, Prenna E, Sartori C, De Vecchi F, Marino PN. Association between left atrial phasic conduit function and early atrial fibrillation recurrence in patients undergoing electrical cardioversion. Clin Res Cardiol 2017; 107:329-337. [PMID: 29181725 PMCID: PMC5869942 DOI: 10.1007/s00392-017-1188-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/23/2017] [Indexed: 01/08/2023]
Abstract
Background Diastolic dysfunction promotes atrial fibrillation (AF) inducing left atrial (LA) remodeling, with chamber dilation and fibrosis. Predominance of LA phasic conduit (LAC) function should reflect not only chamber alterations but also underlying left ventricular (LV) filling impairment. Thus, LAC was tested as possible predictor of early AF relapse after electrical cardioversion (EC). Methods 96 consecutive patients, who underwent EC for persistent non-valvular AF, were prospectively enrolled. Immediately after successful EC (3 h ± 15 min), an echocardiographic apical four-chamber view was acquired with transmitral velocities, annular tissue Doppler and simultaneous LV and LA three-dimensional full-volume datasets. Then, from LA–LV volumetric curves we computed LAC as: [(LV maximum − LV minimum) − (LA maximum − LA minimum) volume], expressed as % LV stroke volume. LA pump, immediately post-EC, was assumed and verified as being negligible. Sinus rhythm persistence at 1 month was checked with ECG-Holter monitoring. Results At 1 month 62 patients were in sinus rhythm and 34 in AF. AF patients presented pre-EC higher E/é values (p = 0.012), no major LA volume differences (p = NS), but a stiffer LV cavity (p = 0.012) for a comparable LV capacitance (p = 0.461). Conduit contributed more (p < 0.001) to LV stroke volume in AF subpopulation. Multiple regression revealed LAC as the most significant AF predictor (p = 0.013), even after correction for biometric characteristics and pharmacotherapy (p = 0.008). Conclusion Our data suggest that LAC larger contribution to LV filling soon after EC reflects LA–LV stiffening, which skews atrioventricular interaction leading to AF perpetuation and makes conduit dominance a powerful predictor of early AF recurrence. Electronic supplementary material The online version of this article (10.1007/s00392-017-1188-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Degiovanni
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy
| | - Enrico Boggio
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy
| | - Eleonora Prenna
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy
| | - Chiara Sartori
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy
| | - Federica De Vecchi
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy
| | - Paolo N Marino
- Department of Translational Medicine, Clinical Cardiology, Università del Piemonte Orientale, Azienda Ospedaliera Universitaria "Maggiore della Carità", Corso Mazzini 18, 28100, Novara, Italy.
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Piccinino C, Giubertoni A, Zanaboni J, Gravellone M, Sola D, Rosso R, Ferrarotti L, Marino PN. Incremental value of right atrial strain for early diagnosis of hemodynamic deterioration in pulmonary hypertension. J Cardiovasc Med (Hagerstown) 2017. [DOI: 10.2459/jcm.0000000000000525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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11
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Assessment of Diastolic Function in Hypertrophic Cardiomyopathy by Computed Tomography–Derived Analysis of Left Ventricular Filling. J Comput Assist Tomogr 2017; 41:339-343. [DOI: 10.1097/rct.0000000000000533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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