Minimum Left Atrial Volume Evaluated by 3D Echocardiography Predicts Atrial Fibrillation Recurrences After a First Radiofrequency Catheter Ablation for Paroxysmal Episodes

Matei, Lavinia-Lucia; Ghilencea, Liviu-Nicolae; Bejan, Gabriel Cristian; Stoica, Sebastian; Dragoi-Galrinho, Ruxandra; Silişte, Cǎlin; Vinereanu, Dragoş

doi:10.26574/maedica.2021.16.3.345

Cited by 5 publications

(4 citation statements)

References 13 publications

(13 reference statements)

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“…Among the various LA imaging parameters, LAVmax has been the most extensively assessed biomarker [ 1 – 5 ]. More recently, there has been increasing interest for LAVmin, which has shown a greater prognostic value than LAVmax [ 23 – 25 ] and may reflect the ‘contractile’ function of the LA more precisely [ 26 , 27 ]. LAEF is another relevant parameter, since it showed the best correlation with E/Eʹ values in a population of patients with diastolic dysfunction assessed by echocardiography [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance

Tondi

Badano

Figliozzi

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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Background The use of apical views focused on the left atrium (LA) has improved the accuracy of LA volume evaluation by two-dimensional (2D) echocardiography. However, routine cardiovascular magnetic resonance (CMR) evaluation of LA volumes still uses standard 2- and 4-chamber cine images focused on the left ventricle (LV). To investigate the potential of LA-focused CMR cine images, we compared LA maximuml (LAVmax) and minimum (LAVmin) volumes, and emptying fraction (LAEF), calculated on both standard and LA-focused long-axis cine images, with LA volumes and LAEF obtained by short-axis cine stacks covering the LA. LA strain was also calculated and compared between standard and LA-focused images. Methods LA volumes and LAEF were obtained from 108 consecutive patients by applying the biplane area-length algorithm to both standard and LA-focused 2- and 4-chamber cine images. Manual segmentation of a short-axis cine stack covering the LA was used as the reference method. In addition, LA strain reservoir (εs), conduit (εe) and booster pump (εa) were calculated using CMR feature-tracking. Results Compared to the reference method, the standard approach significantly underestimated LA volumes (LAVmax: bias − 13 ml; LOA = + 11, − 37 ml; LAVmax i: bias − 7 ml/m2; LOA = + 7, − 21 ml/m2; LAVmin; bias − 10 ml, LOA: + 9, − 28 ml; LAVmin i: bias − 5 ml/m2, LOA: + 5, − 16 ml/m2), and overestimated LA-EF (bias 5%, LOA: + 23, − 14%). Conversely, LA volumes (LAVmax: bias 0 ml; LOA: + 10, − 10 ml; LAVmax i: bias 0 ml/m2; LOA: + 5, − 6 ml/m2; LAVmin: bias − 2 ml; LOA: + 7, − 10 ml; LAVmin i: bias − 1 ml/m2; LOA: + 3, − 5 ml/m2) and LAEF (bias 2%, LOA: + 11, − 7%) by LA-focused cine images were similar to those measured using the reference method. LA volumes by LA-focused images were obtained faster than using the reference method (1.2 vs 4.5 min, p < 0.001). LA strain (εs: bias 7%, LOA = 25, − 11%; εe: bias 4%, LOA = 15, − 8%; εa: bias 3%, LOA = 14, − 8%) was significantly higher in standard vs. LA-focused images (p < 0.001). Conclusion LA volumes and LAEF measured using dedicated LA-focused long-axis cine images are more accurate than using standard LV-focused cine images. Moreover, LA strain is significantly lower in LA-focused vs. standard images.

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Section: Discussionmentioning

confidence: 99%

The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance

Tondi

Badano

Figliozzi

et al. 2023

Journal of Cardiovascular Magnetic Resonance

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“…In sum, the determination of parameters of LA remodeling for predicting patients with high risk of recurrence after CA plays a significant role in assisting clinicians in making more specific therapeutic strategy. LA size can determine the risk of recurrence of AF in patients after CA [ 87 ]. Additionally, LA strain evaluated by 2D-STE has been demonstrated as an independent predictor of AF recurrence after CA [ 88 , 89 , 90 ], however, 2D-STE is limited by its dependency on image quality and the out-of-plane motion of some speckles, which may overestimate LA function [ 68 ].…”

Section: La Structure and Function To Predict The Recurrence Of Af Af...mentioning

confidence: 99%

Assessment of Left Atrial Structure and Function by Echocardiography in Atrial Fibrillation

Gao

et al. 2022

Diagnostics

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Atrial fibrillation (AF) is the most common arrhythmia with significant morbidity and mortality. Exacerbated by the aging population, the prevalence of AF is gradually increasing. Accurate evaluation of structure and function of left atrium (LA) has important prognostic significance in patients with AF. Echocardiography is the imaging technique of first choice to assess LA structure and function due to its better availability, accessibility and safety over cardiac computed tomography and cardiac magnetic resonance. Therefore, the aim of this review is to summarize the recent research progress of evaluating LA size by three-dimensional echocardiography and LA function by speckle tracking echocardiography (STE) in predicting the occurrence and recurrence of AF and determining the risk of stroke in AF. In addition, we summarized the role of traditional echocardiography in detecting AF patients that are at high risk of heart failure or cardiovascular death.

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“…The maximum volume is the most evaluated parameter associated with AF [30,31,39], but more recent studies concentrated on LA minimum volume as a marker of prognosis [40][41][42][43]. Appleton et al [44] showed that minimum LA volume is more closely related to left ventricular filling pressures evaluated invasively, compared to maximum LA volume.…”

Section: Left Atrial Size In Afmentioning

confidence: 99%

“…The maximum volume is the most evaluated parameter associated with AF [ 30 , 31 , 39 ], but more recent studies concentrated on LA minimum volume as a marker of prognosis [ 40 , 41 , 42 , 43 ]. Appleton et al .…”

Section: Left Atrial Size In Afmentioning

confidence: 99%

Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

Matei¹,

Popescu²,

Popescu³

et al. 2022

Rev. Cardiovasc. Med.

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Atrial fibrillation (AF) results from structural and electrical remodeling of the atria, primarily of the left atrium (LA); therefore, LA changes, both anatomical and functional are recognized as proarrhythmic markers with a powerful prognostic value. Being widely available and noninvasive, echocardiography is used to monitor LA form and function in clinical practice. Early functional (electrical) remodeling of the LA precedes anatomical alterations. Impaired LA functions and reduced atrial compliance due to atrial fibrosis may be evaluated using novel echocardiographic techniques, such as tissue Doppler analysis and speckle tracking. Functional evaluation of the LA conveys prognostic information about the risk of AF, as the severity of the impairment is an independent predictor of new-onset AF and AF recurrence. However, specific parameters are still investigated for incorporation into algorithms to predict future AF occurrence. The aim of the review is to summarize echocardiographic parameters, their predicting value and applicability in practice.

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Minimum Left Atrial Volume Evaluated by 3D Echocardiography Predicts Atrial Fibrillation Recurrences After a First Radiofrequency Catheter Ablation for Paroxysmal Episodes

Cited by 5 publications

References 13 publications

The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance

The use of dedicated long-axis views focused on the left atrium improves the accuracy of left atrial volumes and emptying fraction measured by cardiovascular magnetic resonance

Assessment of Left Atrial Structure and Function by Echocardiography in Atrial Fibrillation

Early Echocardiographic Predictors for Atrial Fibrillation Propensity: The Left Atrium Oracle

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