1
|
Park I, Chung S, Cho YH, Sung K, Kim WS, Song K, Ahn JH, Jeon CS, Park PW, Jeong DS. Outcomes of Concomitant Maze Procedure in Tricuspid Repair for Severe Tricuspid Regurgitation. J Korean Med Sci 2024; 39:e143. [PMID: 38651225 PMCID: PMC11035715 DOI: 10.3346/jkms.2024.39.e143] [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: 08/01/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND We aimed to analyze the impact of concomitant Maze procedure on the clinical and rhythm outcomes, and echocardiographic parameters in tricuspid repair for patients with severe tricuspid regurgitation (TR) and persistent atrial fibrillation (AF). METHODS Patients who had severe TR and persistent AF and underwent tricuspid valve (TV) repair were included in the study. Both primary TR and secondary TR were included in the current study. The study population was stratified according to Maze procedure. The primary outcome was major adverse cardiovascular and cerebrovascular event (MACCE) at 15 years post-surgery. Propensity-score matching analyses was performed to adjust baseline differences. RESULTS Three hundred seventy-one patients who underwent tricuspid repair for severe TR and persistent AF from 1994 to 2021 were included, and 198 patients (53.4%) underwent concomitant Maze procedure. The maze group showed 10-year sinus rhythm (SR) restoration rate of 55%. In the matched cohort, the maze group showed a lower cumulative incidence of cardiac death (4.6% vs. 14.4%, P = 0.131), readmission for heart failure (8.1% vs. 22.2%, P = 0.073), and MACCE (21.1% vs. 42.1%, P = 0.029) at 15 years compared to the non-maze group. Left atrial (LA) diameter significantly decreased in the maze group at 5 years (53.3 vs. 59.6 mm, P < 0.001) after surgery compared to preoperative level, and there was a significant difference in the change of LA diameter over time between the two groups (P = 0.013). CONCLUSION The Maze procedure during TV repair in patients with severe TR and persistent AF showed acceptable SR rates and lower MACCE rates compared to those without the procedure, while also promoting LA reverse remodeling.
Collapse
Affiliation(s)
- Ilkun Park
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Suryeun Chung
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yang Hyun Cho
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kiick Sung
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook Sung Kim
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyungsub Song
- Department of Thoracic and Cardiovascular Surgery, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
| | - Joong Hyun Ahn
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Seok Jeon
- Department of Thoracic and Cardiovascular Surgery, Incheon Sejong Hospital, Incheon, Korea
| | - Pyo Won Park
- Department of Thoracic and Cardiovascular Surgery, Incheon Sejong Hospital, Incheon, Korea
| | - Dong Seop Jeong
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
van der Heijden CAJ, Adriaans BP, van Kuijk SMJ, Luermans JGLM, Chaldoupi SM, Maessen JG, Bidar E, Maesen B. Left atrial function of patients with atrial fibrillation undergoing thoracoscopic hybrid ablation. INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY 2024; 38:ivae061. [PMID: 38569919 PMCID: PMC11043019 DOI: 10.1093/icvts/ivae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 04/02/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVES Thoracoscopic hybrid ablation is an effective and safe rhythm control strategy for patients with complex forms of atrial fibrillation. Its effect on left atrial function has not yet been studied. METHODS In a retrospective single-centre analysis of patients undergoing thoracoscopic hybrid ablation, the left atrial emptying fraction was calculated using the biplane modified Simpson method in the apical 2- and 4-chamber views on transthoracic echocardiography. Left atrial strain (reservoir, conduction and contractility) was quantified using dedicated software. RESULTS Sixty-seven patients were included (mean age 64 years, long-standing persistent atrial fibrillation in 69%, median atrial fibrillation history duration 64 months). At baseline, left atrial function and contractility were poor. The reservoir and contractile strain improved postprocedure compared to baseline [15 (standard deviation (SD): 8) and 17 (SD: 6); P = 0.013; 3 (SD: 5) and 4 (SD: 4), P = 0.008], whereas the left atrial volume indexed to the body surface area was reduced [51 ml/m2 (SD: 14) and 47 ml/m2 (SD: 18), P = 0.0024]. In patients with preoperative (long-standing) persistent atrial fibrillation and in patients with rhythm restoration, improvements in the emptying fraction, (reservoir and contractile) strain and the left ventricular ejection fraction were observed, whereas the left atrial volume decreased (P < 0.05). CONCLUSIONS In this cohort of patients with severely diseased left atria, improvement in left atrial contractility and in the emptying fraction after thoracoscopic hybrid ablation for atrial fibrillation in patients with persistent atrial fibrillation is mainly due to rhythm restoration. Interestingly, the procedure itself also results in improved left atrial reservoir strain and reversed left atrial remodelling by reducing left atrial volume.
Collapse
Affiliation(s)
| | - Bouke P Adriaans
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Sander M J van Kuijk
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Justin G L M Luermans
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Sevasti-Marisevi Chaldoupi
- Department of Cardiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Jos G Maessen
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Elham Bidar
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| | - Bart Maesen
- Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
- Cardiovascular Research Institute Maastricht, Maastricht, Netherlands
| |
Collapse
|
3
|
Yu ZX, Yang W, Yin WS, Peng KX, Pan YL, Chen WW, Du BB, He YQ, Yang P. Clinical utility of left atrial strain in predicting atrial fibrillation recurrence after catheter ablation: An up-to-date review. World J Clin Cases 2022; 10:8063-8075. [PMID: 36159552 PMCID: PMC9403688 DOI: 10.12998/wjcc.v10.i23.8063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/03/2022] [Accepted: 07/17/2022] [Indexed: 02/06/2023] Open
Abstract
Rhythm control is the core part of the integrated management of atrial fibrillation (AF), especially in the early stages. Despite advances in catheter ablation (CA), the recurrence rate of AF after CA remains high. As a result, stratification and early management of AF recurrence after CA are critical. Currently, predictors of recurrence of AF after CA are mostly based on dysfunction caused by structural remodeling, apart from traditional risk factors. Atrial strain is a recently developed important parameter for detecting the deformability of atrial myocardium during the cardiac cycle prior to atrial remodeling. Although there is only preliminary evidence, atrial strain is still a promising parameter in predicting the recurrence of AF after CA at an early stage. This review focuses on the evaluation of atrial strain, the current applications of atrial strain in assessing atrial function, and predicting the recurrence of AF after CA. We summarize the contents related as follows: (1) CA for rhythm control in AF; (2) Evaluation methods of atrial strain; (3) Atrial strain in the remodeling and reverse remodeling of AF; and (4) Clinical applications of atrial strain in predicting the recurrence of AF after CA. Although there is accumulating evidence on the role of decreased atrial strain in the early prediction of AF recurrence, atrial strain is limited in clinical practice for lacking exact cut-off values and difficulty in distinguishing specific function phases of the atrium. More research is needed in the future to add strength to the early prediction value of atrial strain in AF recurrences.
Collapse
Affiliation(s)
- Zhi-Xi Yu
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wen Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wei-Si Yin
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Ke-Xin Peng
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Yi-Lin Pan
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Wei-Wei Chen
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Bei-Bei Du
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| | - Yu-Quan He
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Engineering Laboratory for Endothelial Function and Genetic Diagnosis of Cardiovascular Disease, Changchun 130031, Jilin Province, China
| | - Ping Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun 130022, Jilin Province, China
| |
Collapse
|
4
|
Sharma E, Apostolidou E, Sheikh W, Parulkar A, Ahmed MB, Lima FV, McCauley BD, Kennedy K, Chu AF. Hemodynamic effects of left atrial appendage occlusion. J Interv Card Electrophysiol 2021; 64:349-357. [PMID: 34031777 DOI: 10.1007/s10840-021-01006-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Percutaneous left atrial appendage occlusion (LAAO) devices have emerged as alternatives to anticoagulation for embolic stroke prevention in patients with non-valvular atrial fibrillation (NVAF). The left atrial appendage is known to produce vasoactive neuroendocrine hormones involved in cardiovascular homeostasis. The hemodynamic impact of LAA occlusion on cardiac function remains poorly characterized. METHODS This is a single-center, retrospective study of sixty-seven consecutive patients who received LAAO utilizing the WATCHMAN device from May 2017 to June 2019. All patients received a comprehensive 2D transthoracic echocardiogram (TTE) prior to the procedure and a post-procedural TTE. 2D echocardiographic pre-/post-procedural measurements including left ventricular ejection fraction, tricuspid regurgitation, estimated pulmonary artery pressure, diastolic parameters, and left atrial and right ventricular strain were statistically analyzed using the paired t-test. RESULTS Seventy percent of study patients were male with an overall mean age of 73.0 ± 9.0 years. Analysis of post-procedural LAAO revealed statistically significant improvement in left ventricular ejection fraction (52.4 ± 12.6 vs. 56.7 ± 12.7, p < 0.001), an increase in mitral E/e' (14.1 ± 6.5 vs. 18.3 ± 10.8, p < 0.001), and a decrease right ventricular global longitudinal strain (RVGLS) (- 17.5 ± 4.6 vs. - 19.6 ± 5.7, p = 0.027) as compared to pre-procedural TTE. Peak left atrial longitudinal strain (PALS) improved post-LAAO (20.6 ± 12.2 to 22.9 ± 12.9, p = 0.040) with adjustment for cardiac arrhythmias. Post-LAAO, heart failure hospitalizations occurred in 23.9% of patients. CONCLUSIONS Percutaneous LAAO results in real-time atrial and ventricular hemodynamic changes as assessed by echocardiographic evaluation of LV filling pressures (E/e'), PALS, RVGLS, and LVEF.
Collapse
Affiliation(s)
- Esseim Sharma
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA.
| | - Eirini Apostolidou
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Wasiq Sheikh
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Anshul Parulkar
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - M Bilal Ahmed
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Fabio V Lima
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Brian D McCauley
- Department of Cardiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Kevin Kennedy
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Antony F Chu
- Department of Cardiology, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| |
Collapse
|
5
|
Zhang Z, Yang H, Li Y, Han J, Li Y, Meng X, Zhang H. The Effect of Minimally Invasive Thoracoscopic Left Atrial Appendage Excision on Cardiac Dynamic and Endocrine Function. Ann Thorac Cardiovasc Surg 2021; 27:49-55. [PMID: 32814727 PMCID: PMC8043023 DOI: 10.5761/atcs.oa.20-00029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Purpose: Left atrial appendage (LAA) isolation is an effective surgical treatment for decreasing thromboembolic risk. We sought to evaluate the short-term effect of minimally invasive surgery with LAA excision on left atrial dynamic and endocrine function in atrial fibrillation (AF) patients. Methods: A total of 52 patients with paroxysmal AF undergoing minimally invasive surgery with LAA excision in Anzhen Hospital from October 2012 to June 2014 were enrolled in the study. The natriuretic peptide plasma level was determined by enzyme-linked immunosorbent assay (ELISA), and left atrial dynamic function was measured preprocedure by real-time three-dimensional echocardiography and postprocedure after 7 days and 3 months. Results: With the exception of six recurrences, 88.5% (46/52) of the patients were prospectively followed over 3 months in terms of their sinus rhythm postprocedure. No severe operative complications or embolism events occurred within those 3 months. Echocardiography showed a 3–6% decrease in left atrial volume postprocedure, and dynamic function was largely restored by 3 months. There was no significant change in natriuretic peptide levels, although a slight decrease was detected 7 days postprocedure, which gradually recovered by 3 months (P = 0.350). Conclusions: There are no significant differences in left atrial dynamics and natriuretic peptide secretion in AF patients after minimally invasive surgery with LAA excision.
Collapse
Affiliation(s)
- Zhenhua Zhang
- Cardiac Surgery Department, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Haiping Yang
- Cardiac Surgery Department, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Yuehuan Li
- Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Jie Han
- Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yan Li
- Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Xu Meng
- Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Haibo Zhang
- Cardiac Surgery Department, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
6
|
Choi MS, On YK, Jeong DS, Park KM, Park SJ, Kim JS, Carriere KC. Usefulness of Postprocedural Electrophysiological Confirmation Upon Totally Thoracoscopic Ablation in Persistent Atrial Fibrillation. Am J Cardiol 2020; 125:1054-1062. [PMID: 31948665 DOI: 10.1016/j.amjcard.2019.12.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/21/2019] [Accepted: 12/30/2019] [Indexed: 01/10/2023]
Abstract
Little information is available concerning the usefulness of electrophysiological confirmation followed by totally thoracoscopic ablation. This study aimed to examine whether postprocedural electrophysiological confirmation is always necessary after totally thoracoscopic ablation (TTA) in patients with isolated persistent atrial fibrillation. Forty-five patients with isolated persistent atrial fibrillation were randomized into 2 groups those who received routine electrophysiological confirmation and additional catheter ablation after totally thoracoscopic ablation (the hybrid group [n = 22]) and those who did not (the TTA group [n = 23]). Electrophysiological study was performed 4 or 5 days after surgery. No early or late mortality occurred. In the hybrid group, 5 patients (23%, 5/22) required additional ablation due to residual potential in the left atrium. At a year postoperatively, normal sinus rhythm was observed in 89% of patients (40/45) and similar in both groups (Odds ratio 0.80, 95% confidence interval 0.32 to 1.99). During follow-up, sinus rhythm was maintained in 16 patients (70%) in the TTA group without additional catheter ablation, which was similar (p = 0.920) to the results in the hybrid group (n = 15, 68.2%). Event-free survival rate at 12 months did not differ between groups (TTA group vs hybrid group, 78% vs 77%; p = 0.633). In simple Cox regression analysis, preoperative left atrium volume index was associated with atrial arrhythmia (p = 0.030, hazards ratio 1.087, 95% confidence interval 1.01-1.18). In conclusion, thoracoscopic ablation provided good 1-year durability in patients with isolated persistent AF irrespective of postprocedural electrophysiological confirmation. Seventy-percent of the TTA group did not need additional catheter ablation.
Collapse
|
7
|
The Difference in the Changes of Indoxyl Sulfate after Catheter Ablation among Atrial Fibrillation Patients with and without Kidney Dysfunction. Sci Rep 2020; 10:513. [PMID: 31949282 PMCID: PMC6965626 DOI: 10.1038/s41598-020-57421-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/31/2019] [Indexed: 11/21/2022] Open
Abstract
Indoxyl sulfate (IS), a protein-bound uremic toxin, induces chronic kidney disease (CKD) and atrial fibrillation (AF). Catheter ablation (CA) of AF improves the renal function. However, the transition of uremic toxins is unclear. This study aimed to investigate the transition of the serum IS level in AF patients with and without CKD after CA. A total of 138 consecutive AF patients who underwent CA and maintained sinus rhythm were prospectively enrolled (paroxysmal AF 67.4%). The patients were divided into 4 groups (non-CKD/low-IS:68, non-CKD/high-IS:28, CKD/low-IS:13, and CKD/high-IS:29). The plasma IS levels and estimated glomerular filtration rate (eGFR) were determined before and 1-year after CA. CKD was defined as CKD stage III and a high-IS according to the mean IS (IS ≥ 1.1 μg/ml). CA significantly improved the eGFR in CKD patients (p < 0.001). The serum IS level in the non-CKD/high-IS group was significantly decreased (from 1.7 ± 0.7 to 1.1 ± 0.6 μg/ml, p < 0.001). However, the serum IS level in the CKD/high-IS group did not improve (from 1.9 ± 0.9 to 1.7 ± 0.7 μg/ml, p = 0.22). The change in the IS in the CKD patients significantly differed from that in those without CKD. In the CKD patients, CA did not significantly decrease the IS, a risk factor of CKD, regardless of an improved eGFR.
Collapse
|
8
|
Koike H, Morita T, Tatebe J, Watanabe I, Koike M, Yao S, Shinohara M, Yuzawa H, Suzuki T, Fujino T, Ikeda T. The relationship between serum indoxyl sulfate and the renal function after catheter ablation of atrial fibrillation in patients with mild renal dysfunction. Heart Vessels 2018; 34:641-649. [PMID: 30406286 DOI: 10.1007/s00380-018-1288-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 10/26/2018] [Indexed: 01/21/2023]
Abstract
Indoxyl sulfate (IS), a protein-bound uremic toxin, induces renal disorders and atrial fibrillation (AF). It is well known that renal dysfunction is a risk factor for AF and radiofrequency catheter ablation (RFCA) improves the renal function. However, the improvement in the renal function after RFCA in patients with early stage chronic kidney disease (CKD) and the serial changes in the IS level have not been fully elucidated. This study aimed to investigate whether IS affects the improvement in the renal function. A total of 91 consecutive patients with mild kidney dysfunction (CKD stage I-II) who underwent RFCA and maintained sinus rhythm were prospectively enrolled. The plasma IS level and estimated glomerular filtration rate (eGFR) were determined before, 3 months, and 1 year after RFCA. The patients were divided according to the IS quartiles (Q1-4; < 0.4, 0.4-0.7, 0.7-1.2, and > 1.2 μg/ml). There was no significant difference in the eGFR among the IS quartiles. A significantly higher eGFR improvement rate was obtained for IS-Q4 than the other quartiles (p = 0.039). The IS-Q4 IS level significantly decreased at 1 year after RFCA (1.8 ± 0.8 to 1.2 ± 0.7 μg/ml, p < 0.01). The multivariable logistic model revealed that a high-IS level (IS-Q4) was an independent predictor of an eGFR improvement (OR 3.33; 95% CI 1.16-9.59; p = 0.026). A high-IS level reduction after RFCA improved the renal function in AF patients with mild kidney dysfunction.
Collapse
Affiliation(s)
- Hideki Koike
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Toshisuke Morita
- Department of Laboratory Medicine, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Junko Tatebe
- Department of Laboratory Medicine, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Ippei Watanabe
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Makiko Koike
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Shintaro Yao
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Masaya Shinohara
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Hitomi Yuzawa
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Takeya Suzuki
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Tadashi Fujino
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| |
Collapse
|
9
|
Shakti D, Friedman KG, Harrild DM, Gauvreau K, Geva T, Colan SD, Brown DW. Left Atrial Size and Function in Patients With Congenital Aortic Valve Stenosis. Am J Cardiol 2018; 122:1541-1545. [PMID: 30180956 DOI: 10.1016/j.amjcard.2018.07.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2018] [Revised: 07/16/2018] [Accepted: 07/19/2018] [Indexed: 11/24/2022]
Abstract
Little information exists on left atrial (LA) function in healthy children and in patients with congenital aortic valve stenosis (AS). We sought to determine whether patients with significant congenital AS have detectable abnormalities in LA size and function compared with matched normal controls. Retrospective chart review and analysis of 2-dimensional echocardiographic images for phasic left atrial volumes (LAVs) and longitudinal LA strain by speckle tracking in children ≥1 years of age with ≥ moderate isolated congenital AS. LAVs and LA strain in AS cases were compared with age, gender, and body surface area-matched controls (healthy children with a normal echocardiogram). Between June 2004 and October 2012, there were 36 eligible AS cases [age 13 (range 3 to 27) years; 30 males] with a median maximal Doppler gradient of 63 (range 43 to 94) mm Hg. No significant interobserver and intraobserver differences were noted in the analyses of normal subjects. Significantly higher phasic body surface area-adjusted LAVs [preatrial contraction: p = 0.01; minimal: p = 0.04] and higher LA contractile function parameters [indexed active LA stroke volume: p = 0.03; peak negative strain p = 0.04] were noted in AS cases compared with matched controls. In conclusion, compared with normal, children with congenital AS have higher preatrial contraction and minimal phasic LA volumes and higher LA contractile function.
Collapse
|
10
|
Compier MG, Tops LF, Braun J, Zeppenfeld K, Klautz RJ, Schalij MJ, Trines SA. Limited left atrial surgical ablation effectively treats atrial fibrillation but decreases left atrial function. Europace 2017; 19:560-567. [PMID: 28431066 DOI: 10.1093/europace/euw106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/19/2016] [Indexed: 11/15/2022] Open
Abstract
AIMS Limited left atrial (LA) surgical ablation with bipolar radiofrequency is considered to be an effective procedure for treatment of atrial fibrillation (AF). We studied whether limited LA surgical ablation concomitant to cardiac surgery is able to maintain LA function. METHODS AND RESULTS Thirty-six consecutive patients (age 66 ± 12 years, 53% male, 78% persistent AF) scheduled for valve surgery and/or coronary revascularization and concomitant LA surgical ablation were included. Epicardial pulmonary vein isolation (PVI) and additional endo-epicardial lines were performed using bipolar radiofrequency. An age- and gender-matched control group (n = 36, age 66 ± 9 years, 69% male, 81% paroxysmal AF) was selected from patients undergoing concomitant epicardial PVI only. Left atrial dimensions and function were assessed on two-dimensional echocardiography preoperatively and at 3- and 12-month follow-up. Sinus rhythm (SR) maintenance was 67% for limited LA ablation and 81% for PVI at 1-year follow-up (P = 0.18). Left atrial volume decreased from 72 ± 21 to 50 ± 14 mL (31%, P < 0.01) after limited LA ablation and from 65 ± 23 to 56 ± 20 mL (14%, P < 0.01) after PVI. Atrial transport function was restored in 54% of patients in SR after limited LA ablation compared with 100% of patients in SR after PVI. Atrial strain and contraction parameters (LA ejection fraction, A-wave velocity, reservoir function, and strain rate) significantly decreased after limited LA ablation. After PVI, strain and contraction parameters remained unchanged. CONCLUSION Even limited LA ablation decreased LA volume, contraction, transport function, and compliance, indicating both reverse remodelling combined with significant functional deterioration. In contrast, surgical PVI decreased LA volume while function remained unchanged.
Collapse
Affiliation(s)
- Marieke G Compier
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Laurens F Tops
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Jerry Braun
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Robert J Klautz
- Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Martin J Schalij
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - Serge A Trines
- Department of Cardiology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| |
Collapse
|
11
|
Progression of atrial remodeling in patients with high-burden atrial fibrillation: Implications for early ablative intervention. Heart Rhythm 2016; 13:331-9. [DOI: 10.1016/j.hrthm.2015.10.028] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Indexed: 11/20/2022]
|
12
|
TOPLISEK JANEZ, PERNAT ANDREJ, RUZIC NADA, ROBIC BORIS, SINKOVEC MATJAZ, CVIJIC MARTA, GERSAK BORUT. Improvement of Atrial and Ventricular Remodeling with Low Atrial Fibrillation Burden after Hybrid Ablation of Persistent Atrial Fibrillation. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2016; 39:216-24. [DOI: 10.1111/pace.12791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/09/2015] [Accepted: 11/30/2015] [Indexed: 11/28/2022]
Affiliation(s)
- JANEZ TOPLISEK
- Department of Cardiology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - ANDREJ PERNAT
- Department of Cardiology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - NADA RUZIC
- Department of Cardiovascular Surgery; University Medical Center Ljubljana; Ljubljana Slovenia
| | - BORIS ROBIC
- Department of Cardiovascular Surgery; University Medical Center Ljubljana; Ljubljana Slovenia
| | - MATJAZ SINKOVEC
- Department of Cardiology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - MARTA CVIJIC
- Department of Cardiology; University Medical Center Ljubljana; Ljubljana Slovenia
| | - BORUT GERSAK
- Department of Cardiovascular Surgery; University Medical Center Ljubljana; Ljubljana Slovenia
| |
Collapse
|
13
|
Surgical Left Atrial Appendage Exclusion Does Not Impair Left Atrial Contraction Function: A Pilot Study. BIOMED RESEARCH INTERNATIONAL 2015. [PMID: 26221586 PMCID: PMC4508381 DOI: 10.1155/2015/318901] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background. In order to reduce stroke risk, left atrial appendage amputation (LAAA) is widely adopted in recent years. The effect of LAAA on left atrial (LA) function remains unknown. The objective of present study was to assess the effect of LAAA on LA function. Methods. Sixteen patients with paroxysmal AF underwent thoracoscopic, surgical PVI with LAAA (LAAA group), and were retrospectively matched with 16 patients who underwent the same procedure without LAA amputation (non-LAAA group). To objectify LA function, transthoracic echocardiography with 2D Speckle Tracking was performed before surgery and at 12 months follow-up. Results. Mean age was 57 ± 9 years, 84% were male. Baseline characteristics did not differ significantly except for systolic blood pressure (p = 0.005). In both groups, the contractile LA function and LA ejection fraction were not significantly reduced. However, the conduit and reservoir function were significantly decreased at follow-up, compared to baseline. The reduction of strain and strain rate was not significantly different between groups. Conclusions. In this retrospective, observational matched group comparison with a convenience sample size of 16 patients, findings suggest that LAAA does not impair the contractile LA function when compared to patients in which the appendage was unaddressed. However, the LA conduit and reservoir function are reduced in both the LAAA and non-LAAA group. Our data suggest that the LAA can be removed without late LA functional consequences.
Collapse
|
14
|
Wen Z, Ma H, Zhao Y, Fan Z, Zhang Z, Choi SI, Choe YH, Liu J. Left Ventricular Diastolic Dysfunction Assessment with Dual-Source CT. PLoS One 2015; 10:e0127289. [PMID: 25993545 PMCID: PMC4436312 DOI: 10.1371/journal.pone.0127289] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/14/2015] [Indexed: 12/01/2022] Open
Abstract
Purpose To assess the impact of left ventricular (LV) diastolic dysfunction on left atrial (LA) phasic volume and function using dual-source CT (DSCT) and to find a viable alternative prognostic parameter of CT for LV diastolic dysfunction through quantitative evaluation of LA phasic volume and function in patients with LV diastolic dysfunction. Materials and Methods Seventy-seven patients were examined using DSCT and Doppler echocardiography on the same day. Reservoir, conduit, and contractile function of LA were evaluated by measuring LA volume (LAV) during different cardiac phases and all parameters were normalized to body surface area (BSA). Patients were divided into four groups (normal, impaired relaxation, pseudonormal, and restrictive LV diastolic filling) according to echocardiographic findings. The LA phasic volume and function in different stages of LV diastolic function was compared using one-way ANOVA analysis. The correlations between indexed volume of LA (LAVi) and diastolic function in different stages of LV were evaluated using Spearman correlation analysis. Results LA ejection fraction (LAEF), LA contraction, reservoir, and conduit function in patients in impaired relaxation group were not different from those in the normal group, but they were lower in patients in the pseudonormal and restrictive LV diastolic dysfunction groups (P < 0.05). For LA conduit function, there were no significant differences between the patients in the pseudonormal group and restrictive filling group (P = 0.195). There was a strong correlation between the indexed maximal left atrial volume (LAVmax, r = 0.85, P < 0.001), minimal left atrial volume (LAVmin, r = 0.91, P < 0.001), left atrial volume at the onset of P wave (LAVp, r = 0.84, P < 0.001), and different stages of LV diastolic function. The LAVi increased as the severity of LV diastolic dysfunction increased. Conclusions LA remodeling takes place in patients with LV diastolic dysfunction. At the same time, LA phasic volume and function parameters evaluated by DSCT indicated the severity of the LV diastolic dysfunction. Quantitative analysis of LA phasic volume and function parameters using DSCT could be a viable alternative prognostic parameter of LV diastolic function.
Collapse
Affiliation(s)
- Zhaoying Wen
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Heng Ma
- Department of Radiology, Yuhuangding Hospital, Yantai, Shandong Province, China
| | - Ying Zhao
- Department of Echocardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Zhanming Fan
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Zhaoqi Zhang
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Sang Il Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seoul, Republic of Korea
| | - Yeon Hyeon Choe
- Department of Radiology and Cardiovascular and Stroke Imaging Center, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiayi Liu
- Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
- * E-mail:
| |
Collapse
|
15
|
NAVARAVONG LEENHAPONG, BARAKAT MICHEL, BURGON NATHAN, MAHNKOPF CHRISTIAN, KOOPMANN MATTHIAS, RANJAN RAVI, KHOLMOVSKI EUGENE, MARROUCHE NASSIR, AKOUM NAZEM. Improvement in Estimated Glomerular Filtration Rate in Patients with Chronic Kidney Disease Undergoing Catheter Ablation for Atrial Fibrillation. J Cardiovasc Electrophysiol 2014; 26:21-7. [DOI: 10.1111/jce.12530] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 07/22/2014] [Accepted: 07/31/2014] [Indexed: 12/23/2022]
Affiliation(s)
- LEENHAPONG NAVARAVONG
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - MICHEL BARAKAT
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - NATHAN BURGON
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - CHRISTIAN MAHNKOPF
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - MATTHIAS KOOPMANN
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - RAVI RANJAN
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - EUGENE KHOLMOVSKI
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - NASSIR MARROUCHE
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| | - NAZEM AKOUM
- Comprehensive Arrhythmia Research and Management (CARMA) Center; University of Utah Division of Cardiovascular Medicine; Salt Lake City Utah USA
| |
Collapse
|
16
|
Tan TC, Koutsogeorgis ID, Grapsa J, Papadopoulos C, Katsivas A, Nihoyannopoulos P. Left atrium and the imaging of atrial fibrosis: catch it if you can! Eur J Clin Invest 2014; 44:872-81. [PMID: 25066356 DOI: 10.1111/eci.12305] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 07/23/2014] [Indexed: 01/04/2023]
Abstract
Atrial fibrillation is a sustained arrhythmia commonly encountered in clinical practice. It has a high prevalence among the elderly and contributes significantly to the global socio-economic burden. Among many risk factors predisposing to atrial fibrillation is left atrial remodelling and wall fibrosis. Frequently, pathological left atrial wall remodelling and fibrosis results in low atrial compliance and elastance significantly increase the risk of developing permanent atrial fibrillation. We reviewed all literature which employs imaging and left atrial fibrosis and we present all available imaging modalities. Current imaging tools may play a role in the detection of atrial fibrosis, hence providing valuable information for risk stratification and management of patients with atrial fibrillation.
Collapse
Affiliation(s)
- Timothy C Tan
- Department of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | |
Collapse
|
17
|
|
18
|
Vieira MJ, Teixeira R, Gonçalves L, Gersh BJ. Left atrial mechanics: echocardiographic assessment and clinical implications. J Am Soc Echocardiogr 2014; 27:463-78. [PMID: 24656882 DOI: 10.1016/j.echo.2014.01.021] [Citation(s) in RCA: 178] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Indexed: 12/20/2022]
Abstract
The importance of the left atrium in cardiovascular performance has long been acknowledged. Quantitative assessment of left atrial (LA) function is laborious, requiring invasive pressure-volume loops and thus precluding its routine clinical use. In recent years, novel postprocessing imaging methodologies have emerged, providing a complementary approach for the assessment of the left atrium. Atrial strain and strain rate obtained using either Doppler tissue imaging or two-dimensional speckle-tracking echocardiography have proved to be feasible and reproducible techniques to evaluate LA mechanics. It is essential to fully understand the clinical applications, advantages, and limitations of LA strain and strain rate analysis. Furthermore, the technique's prognostic value and utility in therapeutic decisions also need further elucidation. The aim of this review is to provide a critical appraisal of LA mechanics. The authors describe the fundamental concepts and methodology of LA strain and strain rate analysis, the reference values reported with different imaging techniques, and the clinical implications.
Collapse
Affiliation(s)
- Maria J Vieira
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal
| | - Rogério Teixeira
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Departamento de Medicina, Serviço de Cardiologia, Hospital Beatriz Ângelo, Loures, Portugal.
| | - Lino Gonçalves
- Faculdade de Medicina, Universidade de Coimbra, Coimbra, Portugal; Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bernard J Gersh
- Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minnesota
| |
Collapse
|
19
|
Gelsomino S, Lucà F, Rao CM, Parise O, Pison L, Wellens F, Maessen J, La Meir M. Improvement of left atrial function and left atrial reverse remodeling after surgical treatment of atrial fibrillation. Ann Cardiothorac Surg 2014; 3:70-4. [PMID: 24516800 DOI: 10.3978/j.issn.2225-319x.2013.12.03] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 10/30/2013] [Indexed: 11/14/2022]
Affiliation(s)
- Sandro Gelsomino
- Department of Cardiothoracic Surgery, University Hospital, Maastricht, The Netherlands ; ; Department of Heart and Vessels, Careggi Hospital, Florence, Italy
| | - Fabiana Lucà
- Department of Heart and Vessels, Careggi Hospital, Florence, Italy
| | | | - Orlando Parise
- Department of Cardiothoracic Surgery, University Hospital, Maastricht, The Netherlands ; ; Department of Heart and Vessels, Careggi Hospital, Florence, Italy
| | - Laurant Pison
- Department of Heart and Vessels, Careggi Hospital, Florence, Italy
| | - Francis Wellens
- Cardiothoracic Surgery, University Hospital, Brussels, Belgium
| | - Jos Maessen
- Department of Cardiothoracic Surgery, University Hospital, Maastricht, The Netherlands
| | - Mark La Meir
- Department of Cardiothoracic Surgery, University Hospital, Maastricht, The Netherlands ; ; Cardiothoracic Surgery, University Hospital, Brussels, Belgium
| |
Collapse
|
20
|
Wang JG, Xin M, Han J, Li Y, Luo TG, Wang J, Meng F, Meng X. Ablation in selective patients with long-standing persistent atrial fibrillation: medium-term results of the Dallas lesion set. Eur J Cardiothorac Surg 2014; 46:213-20. [DOI: 10.1093/ejcts/ezt593] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
21
|
Hong J, Gu X, An P, Luo T, Lv Q, Kang J, He Y, Hu R, Liu X, Ma C. Left atrial functional remodeling in lone atrial fibrillation: a two-dimensional speckle tracking echocardiographic study. Echocardiography 2013; 30:1051-60. [PMID: 23557171 DOI: 10.1111/echo.12200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess left atrial (LA) functional remodeling in lone atrial fibrillation (LAF) patients via two-dimensional speckle tracking echocardiography (2DSTE). METHODS Forty-five paroxysmal LAF patients and 30 healthy controls underwent 2DSTE in sinus rhythm. Longitudinal LA strain/strain rate (LAS/LASR) of booster, reservoir, and conduit function in apical four- and two-chamber views were measured and averages of the 2 views were used. RESULTS The 2 groups had similarity in LA volume. LAS and LASR of the 3 phasic functions were reduced in patients. Comparing the 2 groups, LA booster strain (LASa) and strain rate were -12.31 ± 3.15 versus -15.30 ± 2.52% and -1.64 ± 0.51 versus -2.08 ± 0.48 1/sec, respectively, P < 0.05 for both. Multivariate regression confirmed that LAF was an independent determinant of LAS/LASR reduction. LASa was the most accurate parameter for differentiating LAF patients from controls (area under receiver operating characteristic curve, 0.763; cutoff value, -14.3%; sensitivity, 71.1% and specificity, 70.0%). Finally, LASa decrement was found to be the only significant predictor of early atrial fibrillation (AF) recurrence (odds ratio [OR], 1.39 per unit decrement; 95% CI, 1.02-1.89; P = 0.038). CONCLUSIONS Remodeling of LA booster pump, reservoir, and conduit function in LAF patients can be detected by 2DSTE before structural remodeling. Occurrence of LAF is associated with impairment of LA intrinsic myocardial properties. LASa can differentiate LAF patients and lower LASa is associated with early recurrence of AF after ablation.
Collapse
Affiliation(s)
- Jin Hong
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China
| | | | | | | | | | | | | | | | | | | |
Collapse
|