Clinical Significance of the Assessment of the Systolic and Diastolic Myocardial Function of the Left Atrium in Patients With Paroxysmal Atrial Fibrillation and Low CHADS2 Index Treated With Catheter Ablation Therapy

Morris, Daniel A.; Parwani, Abdul Shokor; Huemer, Martin; Wutzler, Alexander; Bekfani, Tarek; Attanasio, Philipp; Friedrich, Katharina; Kühnle, York; Haverkamp, Wilhelm; Boldt, Leif‐Hendrik

doi:10.1016/j.amjcard.2012.12.021

Cited by 50 publications

(49 citation statements)

References 23 publications

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“…19,20,[26][27][28] Our results are in accordance with a study by Morris et al 19 using LA strain pattern using echocardiographic measures, showing that AF ablation outcomes are correlated with the LA systolic and diastolic function. In another report, PV flow velocities measured by echocardiography were inversely associated with recurrence after CA in a relatively small study of 67 AF patients.…”

Section: Discussionsupporting

confidence: 82%

“…We suspect this is because of ablation-induced myocardial scarring, which has been reported previously. 19 Postablation stiff LA syndrome has been described and is reported to occur in 1.4% of patients. 25 LA stiffness in this study was defined by elevated estimated pulmonary artery pressure on transthoracic echocardiography, which could be confounded by the presence of pulmonary hypertension or congestive failure.…”

Section: Discussionmentioning

confidence: 99%

“…[19][20][21] Most studies on LA diastolic function have used echocardiographic speckle tracking to assess strain and indirectly evaluate myocardial compliance. 19,22 Other groups have investigated the atrial diastolic function by CMR, again based entirely on changes in LA volume. 23 The LA strain technique uses movement of the myocardium in a cardiac cycle and is unable to assess the LAP.…”

Section: Discussionmentioning

confidence: 99%

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Association Between Left Atrial Stiffness Index and Atrial Fibrillation Recurrence in Patients Undergoing Left Atrial Ablation

Khurram

Maqbool

Berger

et al. 2016

Circ: Arrhythmia and Electrophysiology

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Background-Atrial fibrillation (AF) is associated with significant abnormalities of left atrial (LA) systolic and diastolic function. This study describes a novel measure, LA stiffness index, that estimates LA diastolic function and its association with clinical outcomes of catheter ablation. Methods and Results-A total of 219 AF patients referred for ablation (59% paroxysmal, mean CHA 2 DS 2 VASc score 1.7±1.4) were enrolled. Atrial pressure and volume loops were prepared from invasive pressure measures and cardiac magnetic resonance imaging volumetric data during sinus rhythm for all patients. An LA stiffness index was created, defined by the ratio of change in LA pressure to volume during passive filling of LA (ΔP/ΔV). Patients were followed prospectively. Mean LA stiffness index for AF patients was 0.6±0.5 mm Hg/mL (paroxysmal AF 0.51±0.4 and persistent AF 0.73±0.6; P<0.001). Linear regression analysis showed a rise in the stiffness index with age, increasing at a rate of 0.02 mm Hg/mL per year (P<0.001). The LA stiffness index was higher in patients with previous LA ablation(s) for AF (0.51±0.35 versus 0.83±0.70; P<0.001). Forty of 160 patients had recurrence after AF ablation with a mean follow-up of 10.4±7.6 months. Patients with recurrence had higher stiffness index than those without recurrence (0.83±0.46 versus 0.40±0.22; P<0.001). Conclusions-LA stiffness index, a novel measure to assess LA diastolic function, increases with age and is higher in persistent AF and in the setting of repeat AF ablation. Greater LA stiffness index was independently associated with recurrence of AF after LA ablation. (Circ Arrhythm Electrophysiol. 2016;9:e003163.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Association Between Left Atrial Stiffness Index and Atrial Fibrillation Recurrence in Patients Undergoing Left Atrial Ablation

Khurram

Maqbool

Berger

et al. 2016

Circ: Arrhythmia and Electrophysiology

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“…При одномерном регрессионном анализе Кокса эхокардиографических параметров, включавших диаметр ЛП более 40 мм, макси-мальный объем ЛП более 28 мл/м 2 и индекс рас-ширения менее 65%, самыми сильными факто-рами, связанными с рецидивом ФП, были пока-затели GLSs более -10% (ОР 4,95 (3,(15)(16)(17)(18)(19)95), р = 0,002), GLSr менее 15% (ОР 6,7 (2,4-14,9), р < 0,001) и GLSRs менее 1,6 с -1 (ОР 7,8 (3,4-17,8), р = 0,007), характеризующие механи-ческую функцию ЛП. C. Schneider et al показа-ли, что значения параметров деформации ЛП увеличиваются у пациентов со стабильным си-нусовым ритмом после катетерной аблации в те-чение периода наблюдения, в отличие от боль-ных с рецидивами ФП [9].…”

Section: Discussionunclassified

“…3). В одномерном регрессионном анализе Кокса среди достоверных механических параме-тров самыми сильными факторами, связанными с рецидивом ФП, были показатели GLSs более -10% (ОР 4,95 (3,(15)(16)(17)(18)(19)95), р = 0,002), GLSr ме-нее 15% (ОР 6,7 (2,4-14,9), р < 0,001) и GLSRs менее 1,6 с -1 (ОР 7,8 (3,4-17,8), р = 0,007) (см. табл.…”

Section: геометрические и функциональные особенности левого предсердиunclassified

Evaluation of geometric, functional and mechanical parameters of left atrium remodeling after surgical treatment of isolated atrial fibrillation

Khazhbieva¹,

Tembotova²,

Serguladze³

et al. 2018

Ann aritmol

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Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT

Chen

Yang

et al. 2016

Eur Radiol

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Clinical Significance of the Assessment of the Systolic and Diastolic Myocardial Function of the Left Atrium in Patients With Paroxysmal Atrial Fibrillation and Low CHADS2 Index Treated With Catheter Ablation Therapy

Cited by 50 publications

References 23 publications

Association Between Left Atrial Stiffness Index and Atrial Fibrillation Recurrence in Patients Undergoing Left Atrial Ablation

Association Between Left Atrial Stiffness Index and Atrial Fibrillation Recurrence in Patients Undergoing Left Atrial Ablation

Evaluation of geometric, functional and mechanical parameters of left atrium remodeling after surgical treatment of isolated atrial fibrillation

Assessments of pulmonary vein and left atrial anatomical variants in atrial fibrillation patients for catheter ablation with cardiac CT

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