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Çamcı S, Arı H, Arı S, Melek M, Bozat T. The Predictive Value of the Left Atrial Kinetic Energy for Atrial Fibrillation Recurrence. Cureus 2022; 14:e28714. [PMID: 36211102 PMCID: PMC9529022 DOI: 10.7759/cureus.28714] [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] [Accepted: 09/02/2022] [Indexed: 11/30/2022] Open
Abstract
Background and aim Determining which patients will experience recurrence of atrial fibrillation (AF) is crucial for treatment modification. This study aimed to investigate the predictive value of left atrial kinetic energy (LAKE) in AF recurrence. Materials and methods A total of 120 consecutive patients who achieved sinus rhythm (SR) with electrical direct current cardioversion and met the inclusion criteria were included in the study. Transthoracic echocardiography (TTE) and LAKE values were calculated on the first day after cardioversion. Rhythm control was performed with 12-lead electrocardiography in the first-month follow-up. Results While 81 (67.5%) patients were in SR at one month, AF recurrence was detected in 39 (32.5%) patients. In the AF group, AF duration, cardioversion energy, number of diabetic patients, left atrium (LA) diameter, LA pre-mitral A wave volume, LA minimum volume, and pulmonary artery pressure values were significantly higher than in the SR group, while mitral A wave velocity and LAKE values were significantly lower. In multivariate regression analysis, AF duration (OR: 1.54; 95% CI: 1.22 - 1.93; p < 0.001), LA diameter (OR: 1.33; 95% CI: 1.10 - 1.61; p = 0.002), and LAKE (OR: 0.96; 95% CI: 0.94 - 0.99; p = 0.007) were determined to be independent predictors of AF recurrence at one month. Conclusions LA diameter, AF duration, and LAKE were found to be significant predictors of AF recurrence after cardioversion.
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Karakus A, Uğuz B. An early echocardiographic prediction for functional myocardial recovery after ST elevation myocardial infarction. KARDIOLOGIIA 2021; 61:66-71. [PMID: 33706689 DOI: 10.18087/cardio.2021.1.n1477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/04/2021] [Accepted: 01/08/2021] [Indexed: 06/12/2023]
Abstract
Goals Discrimination of the time course of functional recovery in early period following ST elevation myocardial infarction (STEMI) has prognostic importance. This study aims to establish the ability of the combined systolic-diastolic index (E / (Ea x Sa), for differentiating recoverable myocardium or persistent non-viability in subjects with STEMI.Material and methods 77 patients with first acute STEMI were enrolled to the study. Serial transthoracic echocardiography (TTE) examinations were performed at the time of the admission (immediately after reperfusion), hospital discharge (5±1 days) and control examination (30±2 days). To assess the association between E / (Ea×Sa) index and myocardial recovery, two categories (Transient stunning and persistent non-viability) were defined on basis of improvement of left ventricle ejection fraction (LV EF) (Improvement was defined as an increase more than 10 % in LV EF at day 30 compared to baseline).Results 55 patients (71.4 %) had improvement of LV EF and 24 patients (28.6 %) had no recovery of systolic function (30 days LV EF 48.78±6.1 vs. 39.31±8.1 %, p=0.01). The E / (Ea×Sa) index were significantly higher in the "non-viability" than in stunning group on predischarge and 1 month (1.61±0.64 vs 1.25±0.43, p=0.01 and 1.33±0.25 vs 1.14±0.21, p=0.01, respectively). The change in the E / (Ea×Sa) index in early period (within 5±1 days) was higher in the stunning group (26 %) compared to non-viability group (15 %) (p=0.033). E / (Ea×Sa) index was found to be a significant predictor of myocardial recovery in multivariable logistic regression (OR 0.91, 95 % CI 0.83-0.98, p=0.001). Roc curve showed that the cutoff value of E / (Ea×Sa) index is 1.29 with 73 % of sensitivity and 61 % of specificity (AUC: 0.71, p=0.01, CI: 0.54-0.89).Conclusions Our findings suggest that E / (Ea×Sa) index is a strong predictor of functional recovery; the odds of recovery decreases as E / (Ea×Sa) index value increases.
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Affiliation(s)
- Alper Karakus
- Department of Cardiology, Besni State Hospital, Adıyaman, Turkey
| | - Berat Uğuz
- Department of Cardiology, Bursa City Hospital, Bursa, Turkey
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Karaliute R, Jureviciute J, Jurgaityte J, Rimkute A, Mizariene V, Baksyte G, Kazakevicius T, Urboniene D, Kavoliuniene A. The Predictive Value of Tissue Doppler Indices for Early Recurrence of Atrial Fibrillation After Electrical Cardioversion. Clin Interv Aging 2020; 15:1917-1925. [PMID: 33116446 PMCID: PMC7548222 DOI: 10.2147/cia.s263303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 07/19/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose Spectral tissue Doppler-derived E/e’ ratio has been proposed as the best parameter for prediction of atrial fibrillation (AF). Relaxation and contraction are equivalent parts of a continuous cardiac cycle, where systolic and diastolic abnormalities have a variable contribution to the left ventricle (LV) failure. The aim of this study was to investigate whether the E/(e’xs’) ratio is a better index than E/e‘ to predict AF recurrence and to determine the changes of spectral tissue Doppler indices 1 month after the electrical cardioversion (ECV). Patients and Methods The study included 77 persistent AF patients with restored sinus rhythm (SR) after ECV. Only patients with normal LV ejection fraction (EF) were included. Echocardiography and NT-proBNP laboratory findings were performed. A primary outcome was the early (within 1 month) recurrence of AF. Results After a 1 month follow-up period, 39 patients (50.6%) were in SR. E/e′ (HR=1.74, P=0.001) and E/(e’×s’) ratios (HR=8.17, P=0.01) were significant predictors of AF recurrence. E/(e’×s’) in combination with LV end-diastolic diameter >49.3 mm and NT-proBNP >2000 ng/L demonstrated a higher contribution in the model to predict AF recurrence compared to the E/e’ ratio (18.94, P=0.005 vs 1.95, P=0.001). On ROC analysis, E/(e’×s’) and E/e′ showed similar diagnostic accuracy (E/(e’×s’), AUC=0.71, P=0.002 and E/e′, AUC=0.75, P<0.0001). Average e‘ value significantly decreased after 1 month in SR (from 10.76±1.24 to 8.96±1.47 cm/s, P=0.01), E wave did not change significantly and E/e′ ratio tended to improve. A decrease of average e‘ and an increase of average s‘ values led to significant improvement of E/(e’xs’) ratio. Conclusion E/(e’xs’) and E/e’ ratios are comparable to predict early AF recurrence after ECV in patients with persistent AF. The e’ value decreased significantly after 1 month follow-up period after ECV for persistent AF patients.
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Affiliation(s)
- Rasa Karaliute
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Justina Jureviciute
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Julija Jurgaityte
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Agne Rimkute
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vaida Mizariene
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Giedre Baksyte
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tomas Kazakevicius
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Daiva Urboniene
- Department of Laboratory Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ausra Kavoliuniene
- Department of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Ari S, Ari H, Tütüncü A, Çamci S, Vatansever Ağca F, Melek M. A novel index combining diastolic and systolic tissue Doppler parameters for predicting cardiac resynchronization therapy response. Echocardiography 2020; 37:1184-1191. [DOI: 10.1111/echo.14797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/02/2020] [Accepted: 07/05/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Selma Ari
- Department of Cardiology Bursa Postgraduate Hospital Bursa Turkey
| | - Hasan Ari
- Department of Cardiology Bursa Postgraduate Hospital Bursa Turkey
| | - Ahmet Tütüncü
- Department of Cardiology Bursa Postgraduate Hospital Bursa Turkey
| | - Sencer Çamci
- Department of Cardiology Bursa Postgraduate Hospital Bursa Turkey
| | | | - Mehmet Melek
- Department of Cardiology Bursa Postgraduate Hospital Bursa Turkey
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Camci S, Ari S, Karakus A, Ari H, Taner T. The predictive value of the combined systolic-diastolic index for atrial fibrillation after coronary artery bypass surgery. Echocardiography 2020; 37:1177-1183. [PMID: 32735049 DOI: 10.1111/echo.14806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/06/2020] [Accepted: 07/13/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a factor that causes an increase in mortality and morbidity. Therefore, predicting post-CABG AF development is important for treatment management. In this study, we investigated the value of the ratio E/(Ea × Sa) as a combined systolic-diastolic index in predicting post-CABG AF development. METHODS This prospective study included 102 patients who underwent only isolated coronary bypass. Preoperative demographic features, biochemical, and hematological parameters, and the electrocardiographic data of all patients were recorded. The E/(Ea × Sa) indices were calculated from the echocardiographic measurements. Those who retained their postoperative sinus rhythm were defined as group 1, and those who developed AF were defined as group 2. RESULTS Group 2 had significantly higher lateral (group 1:1.14 ± 0.61 vs. group 2:1.47 ± 0.87; P = .02), medial (group 1:1.61 ± 0.70 vs. group 2:1.99 ± 0.91; P = .02), and mean (group 1:1.30 ± 0.58 vs. group 2:1.62 ± 0.74; P = .001) E/(Ea × Sa) indices than group 1. In the univariate analysis, age, CHA2 DS2 -VASc score, sPAP, IABP use, and mean E/(EaxSa) index were found to be significant predictors of post-CABG AF development. However, only the mean E/(EaxSa) index was found to be a significant predictor of post-CABG AF development in the multivariate analysis (OR: 2.19 95% CI 1.01-5.96; P = .045). CONCLUSIONS The combined systolic-diastolic index predicted the development of post-CABG AF.
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Affiliation(s)
- Sencer Camci
- Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey
| | - Selma Ari
- Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey
| | - Alper Karakus
- Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey
| | - Hasan Ari
- Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey
| | - Temmuz Taner
- Department of Cardiovascular Surgery, Bursa Postgraduate Hospital, Bursa, Turkey
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Gumprecht J, Szulik M, Domek M, Mazurek M, Shantsila A, Oxborough D, Lip GYH. Novel Echocardiographic Biomarkers in the Management of Atrial Fibrillation. CURRENT CARDIOVASCULAR IMAGING REPORTS 2019. [DOI: 10.1007/s12410-019-9520-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
Purpose of Review
Atrial fibrillation (AF) is the most common arrhythmia in adults. The number of patients with AF is anticipated to increase annually, mainly due to the aging population alongside improved arrhythmia detection. AF is associated with a significantly elevated risk of hospitalization, stroke, thromboembolism, heart failure, and all-cause mortality. Echocardiography is one of the key components of routine assessment and management of AF. Therefore, the aim of this review is to briefly summarize current knowledge on “novel” echocardiographic parameters that may be of value in the management of AF patients.
Recent Findings
Novel echocardiographic biomarkers and their clinical application related to the management of AF have been taken into consideration. Both standard parameters such as atrial size and volume but also novels like atrial strain and tissue Doppler techniques have been analyzed.
Summary
A number of novel echocardiographic parameters have been proven to enable early detection of left atrial dysfunction along with increased diagnosis accuracy. This concerns particularly experienced echocardiographers. Hence, these techniques might improve the prediction of stroke and thromboembolic events among AF patients and need to be further developed and disseminated. Nonetheless, even the standard imaging parameters could be of significant value and should not be discontinued in everyday clinical practice.
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Arques S. [Why not integrate the spectral tissue Doppler E/(e'xs') in the multiparametric assessment of cardiovascular diseases by transthoracic Doppler echocardiography?]. Ann Cardiol Angeiol (Paris) 2019; 68:358-362. [PMID: 31466722 DOI: 10.1016/j.ancard.2019.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 07/22/2019] [Indexed: 06/10/2023]
Abstract
Assessment of left ventricular diastolic function by transthoracic Doppler echocardiography is based on a multiparametric approach which includes the spectral tissue Doppler-derived E/e'. Recently, a new Doppler index, E/(e'xs'), which combines E/e' with a spectral tissue Doppler-derived marker of systolic function, s', has been proposed in noninvasive assessment of left ventricular myocardial dysfunction. Current literature provides evidence that E/(e'xs') has good correlation with NT proBNP levels and invasive left ventricular end-diastolic pressure, both used as markers of left ventricular myocardial dysfunction, irrespective of left ventricular ejection fraction and wall motion abnormalities. More specifically, E/(e'xs') has good diagnostic accuracy in patients with intermediate values for E/e' (8 to 15). Average E/(e'xs')>1.6 is reported to predict invasive left ventricular end-diastolic pressure>15mmHg with a sensitivity of 86% and a specificity of 85%. Current literature provides evidence that E/(e'xs') could offer better prognostic information than E/e' in patients with systolic heart failure and heart failure with normal ejection fraction, as well as in patients with asymptomatic heart disease. A few clinical studies also suggest that E/(e'xs') could predict recurrence of atrial fibrillation after cardioversion and left ventricular remodeling after acute myocardial infarction. Further experimental and clinical investigation is critically needed to determine the role of this under-recognized tissue Doppler index in noninvasive assessment of cardiovascular diseases, in particular heart failure with normal ejection fraction.
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Affiliation(s)
- S Arques
- Unité fonctionnelle de cardiologie, centre hospitalier Edmond-Garcin, avenue des Soeurs-Gastine, 13400 Aubagne, France.
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Ari H, Ari S. Reply. Echocardiography 2016; 33:1275. [DOI: 10.1111/echo.13286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Hasan Ari
- Department of Cardiology; Bursa Yuksek Ihtisas Hospital; Bursa Turkey
| | - Selma Ari
- Department of Cardiology; Bursa Yuksek Ihtisas Hospital; Bursa Turkey
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Wang F, Ke HY, Zhu B. A novel index combining diastolic and systolic tissue Doppler parameters for prediction of atrial fibrillation recurrence. Klotho: a potential biomarker to indicate coronary flow reserve? Echocardiography 2016; 33:1273-4. [PMID: 27343010 DOI: 10.1111/echo.13287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Fu Wang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Hai-Yan Ke
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Bin Zhu
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
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